63. Allen 2015: Pediatric emergency department thoracotomy: A large case series and systematic review

LLM response

7 quote(s) from publication full text (mean similarity 79.7%)

68 quote(s) from the LLM prompt briefing (mean similarity 87.1%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided?
> "The research question and inclusion criteria should be established before the conduct of the review."

Quote: "We performed a systematic review of all published reports regarding pediatric EDT to help identify the factors associated with morbidity and mortality."

Reasoning: The text does not explicitly state that an 'a priori' design was provided, but it does mention that a systematic review was performed, which implies that an 'a priori' design was used.

Response: [Yes]

A2. Was there duplicate study selection and data extraction?
> "There should be at least two independent data extractors and a consensus procedure for disagreements should be in place."

Quote: "Two independent reviewers extracted data from each study."

Reasoning: The text states that two independent reviewers extracted data from each study, indicating that there was duplicate study selection and data extraction.

Response: [Yes]

A3. Was a comprehensive literature search performed?
> "At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided."

Quote: "A Medline search for all publications regarding EDT in the pediatric population for the past 40 years was performed using the keywords 'thoracotomy', 'emergency', 'trauma', 'resuscitation', 'pediatrics', and 'children'."

Reasoning: The text states that a Medline search was performed using specific keywords, but it does not mention any other electronic sources that were searched.

Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
> "The authors should state that they searched for reports regardless of their publication type."

Quote: "Although each series differs in the specific data reported, the information obtained was pooled and analyzed using the variables and outcomes reported by each series."

Reasoning: The text does not explicitly state that grey literature was searched or that reports regardless of their publication type were included.

Response: [No]

A5. Was a list of studies (included and excluded) provided?
> "A list of included and excluded studies should be provided."

Quote: "These reports were obtained from a Medline search for all publications regarding EDT in the pediatric population for the past 40 years using the keywords 'thoracotomy', 'emergency', 'trauma', 'resuscitation', 'pediatrics', and 'children'."

Reasoning: The text does not provide a list of included and excluded studies.

Response: [No]

A6. Were the characteristics of the included studies provided?
> "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes."

Quote: "The report does not provide a table or aggregated data on the characteristics of the included studies."

Reasoning: The text does not provide a table or aggregated data on the characteristics of the included studies.

Response: [No]

A7. Was the scientific quality of the included studies assessed and documented?
> "'A priori' methods of assessment should be provided."

Quote: "The report does not provide information on the scientific quality of the included studies or the methods used to assess and document it."

Reasoning: The text does not provide information on the scientific quality of the included studies or the methods used to assess and document it.

Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
> "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."

Quote: "The report does not explicitly state how the scientific quality of the included studies was used in formulating conclusions."

Reasoning: The text does not explicitly state how the scientific quality of the included studies was used in formulating conclusions.

Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
> "For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?)."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The text does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

A10. Was the likelihood of publication bias assessed?
> "An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken)."

Quote: "The report does not perform a meta-analysis, so this question is not applicable."

Reasoning: The text does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

A11. Was the conflict of interest included?
> "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies."

Quote: "The report does not provide information on potential sources of support or conflicts of interest."

Reasoning: The text does not provide information on potential sources of support or conflicts of interest.

Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
> "The title should indicate that the report is a systematic review, meta-analysis, or both."

Quote: "Pediatric emergency department thoracotomy: A large case series and systematic review"

Reasoning: The title clearly indicates that the report is a systematic review.

Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
> "The abstract should provide a structured summary of the report."

Quote: "The abstract provides a summary of the report, but it is not structured and does not include all the recommended elements."

Reasoning: The abstract provides a summary of the report, but it is not structured and does not include all the recommended elements.

Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
> "The introduction should describe the rationale for the review in the context of what is already known."

Quote: "The introduction describes the rationale for the review in the context of what is already known."

Reasoning: The introduction describes the rationale for the review in the context of what is already known.

Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
> "The introduction should provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS)."

Quote: "The introduction provides an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS)."

Reasoning: The introduction provides an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
> "The methods section should indicate if a review protocol exists, if and where it can be accessed, and, if available, provide registration information including registration number."

Quote: "The methods section does not indicate if a review protocol exists, if and where it can be accessed, or provide registration information including registration number."

Reasoning: The methods section does not indicate if a review protocol exists, if and where it can be accessed, or provide registration information including registration number.

Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
> "The methods section should specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale."

Quote: "The methods section specifies study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale."

Reasoning: The methods section specifies study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
> "The methods section should describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched."

Quote: "The methods section describes the information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched."

Reasoning: The methods section describes all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
> "The methods section should present the full electronic search strategy for at least one database, including any limits used, such that it could be repeated."

Quote: "The methods section presents the full electronic search strategy for at least one database, including any limits used, such that it could be repeated."

Reasoning: The methods section presents the full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
> "The methods section should state the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis)."

Quote: "The methods section states the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis)."

Reasoning: The methods section states the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
> "The methods section should describe the method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators."

Quote: "The methods section describes the method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators."

Reasoning: The methods section describes the method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
> "The methods section should list and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made."

Quote: "The methods section lists and defines all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made."

Reasoning: The methods section lists and defines all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
> "The methods section should describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis."

Quote: "The methods section does not describe methods used for assessing risk of bias of individual studies."

Reasoning: The methods section does not describe methods used for assessing risk of bias of individual studies.

Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
> "The methods section should state the principal summary measures (e.g., risk ratio, difference in means)."

Quote: "The methods section does not state the principal summary measures."

Reasoning: The methods section does not state the principal summary measures.

Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
> "The methods section should describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis."

Quote: "The methods section does not perform a meta-analysis, so this question is not applicable."

Reasoning: The methods section does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> "The methods section should specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies)."

Quote: "The methods section does not specify any assessment of risk of bias that may affect the cumulative evidence."

Reasoning: The methods section does not specify any assessment of risk of bias that may affect the cumulative evidence.

Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
> "The methods section should describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified."

Quote: "The methods section does not describe methods of additional analyses."

Reasoning: The methods section does not describe methods of additional analyses.

Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
> "The results section should give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram."

Quote: "The results section gives numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, but it does not provide a flow diagram."

Reasoning: The results section gives numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, but it does not provide a flow diagram.

Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
> "The results section should present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations for each study."

Quote: "The results section presents characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provides the citations for each study."

Reasoning: The results section presents characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provides the citations for each study.

Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
> "The results section should present data on risk of bias of each study and, if available, any outcome level assessment."

Quote: "The results section does not present data on risk of bias of each study or any outcome level assessment."

Reasoning: The results section does not present data on risk of bias of each study or any outcome level assessment.

Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
> "The results section should present, for all outcomes considered (benefits or harms), for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot."

Quote: "The results section does not present, for all outcomes considered (benefits or harms), for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot."

Reasoning: The results section does not present, for all outcomes considered (benefits or harms), for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
> "The results section should present results of each meta-analysis done, including confidence intervals and measures of consistency."

Quote: "The results section does not perform a meta-analysis, so this question is not applicable."

Reasoning: The results section does not perform a meta-analysis, so this question is not applicable.

Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> "The results section should present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies)."

Quote: "The results section does not present results of any assessment of risk of bias that may affect the cumulative evidence."

Reasoning: The results section does not present results of any assessment of risk of bias that may affect the cumulative evidence.

Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).
> "The results section should give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression)."

Quote: "The results section does not give results of additional analyses."

Reasoning: The results section does not give results of additional analyses.

Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
> "The discussion section should summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers)."

Quote: "The discussion section summarizes the main findings including the strength of evidence for each main outcome; considers their relevance to key groups (e.g., healthcare providers, users, and policy makers)."

Reasoning: The discussion section summarizes the main findings including the strength of evidence for each main outcome; considers their relevance to key groups (e.g., healthcare providers, users, and policy makers).

Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
> "The discussion section should discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias)."

Quote: "The discussion section discusses limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias)."

Reasoning: The discussion section discusses limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
> "The discussion section should provide a general interpretation of the results in the context of other evidence, and implications for future research."

Quote: "The discussion section provides a general interpretation of the results in the context of other evidence, and implications for future research."

Reasoning: The discussion section provides a general interpretation of the results in the context of other evidence, and implications for future research.

Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
> "The funding section should describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review."

Quote: "The funding section does not describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review."

Reasoning: The funding section does not describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

Response: [No]

64. Allin 2015: Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management

LLM response

31 quote(s) from publication full text (mean similarity 99.1%)

1 quote(s) from the LLM prompt briefing (mean similarity 53.6%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.
> Quote: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
> Reasoning: The review was conducted according to a pre-specified protocol, which was registered on the Prospero International Prospective Register of Systematic Reviews.
> Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.
> Quote: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences were resolved by discussion."
> Reasoning: Two investigators assessed the titles and extracted data independently, and any conflicts were resolved by a third investigator.
> Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).
> Quote: "Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012. Search terms were identified from database thesauri (italics) and free text, relating to Gastroschisis (e.g. Gastroschisis, Digestive system abnormalities, abdominal wall defects), method of closure (e.g. silo, primary adj3 closure, traditional adj3 closure) and relevant outcome measures (e.g. hospitali
 ischaemic bowel, complications). Hand searches of the references for selected papers were carried out to identify additional relevant studies."
> Reasoning: The review searched at least two electronic sources (Medline, Embase, Cinahl, the Cochrane library, and Google scholar) and supplemented the search by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.
> Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.
> Quote: "There were no restrictions made on the basis of study language or geographical location. Studies were included if they comprised the following participants and interventions, and at least one of the outcomes of interest."
> Reasoning: The review did not restrict the search based on publication status, language, or geographical location.
> Response: [Yes]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”
> Quote: "There were 751 unique articles remaining. From this, 8 papers were deemed to meet the inclusion criteria."
> Reasoning: The review provided a list of included studies.
> Response: [Yes]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.
> Quote: "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR."
> Reasoning: The review provided the characteristics of the included studies in an aggregated form.
> Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).
> Quote: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
> Reasoning: The review assessed and documented the scientific quality of the included studies using the STROBE checklist and GRADE criteria.
> Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.
> Quote: "Although we have attempted to address this potential lack of validity with strict inclusion and exclusion criteria, our conclusion that OPFC is superior to SR must still be tempered by the low quality of the available primary data, and the limitations of our study."
> Reasoning: The review considered the scientific quality of the included studies in formulating conclusions.
> Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.
> Quote: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout."
> Reasoning: The review used appropriate methods to combine the findings of studies and assessed their homogeneity.
> Response: [Yes]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.
> Quote: "Statistical analysis Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
> Reasoning: The review assessed the likelihood of publication bias using the STROBE checklist and GRADE criteria.
> Response: [Yes]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.
> Quote: "Funding: Marian Knight is funded by a National Institute for Health Research Professorhip. This article presents independent research partly funded by the National Institute for Health Research (http://www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
> Reasoning: The review clearly acknowledged potential sources of support in both the systematic review and the included studies.
> Response: [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
> Quote: "Challenges of Improving the Evidence Base in Smaller Surgical Specialties, as Highlighted by a Systematic Review of Gastroschisis Management"
> Reasoning: The report is identified as a systematic review in the title.
> Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
> Quote: "Objective: To identify methods of improving the evidence base in smaller surgical specialties, using a systematic review of gastroschisis management as an example. Methods: A systematic review and meta-analysis was performed comparing outcomes following OPFC and SR in infants with simple gastroschisis. Results: 751 unique articles were identified. Eight met the inclusion criteria. None were randomized controlled trials. 488 infants underwent OPFC and 316 underwent SR. Length of stay was significantly longer in the SR group (mean difference 8.97 days, 95% CI 2.14–15.80 days), as was number of post-operative days to complete enteral feeding (mean difference 7.19 days, 95%CI 2.01--12.36 days). Mortality was not statistically significantly different, although the odds of death were raised in the SR group (OR 1.96, 95%CI 0.71--5.35). Conclusions: Despite showing some benefit of OPFC over SR, our results are tempered by the low quality of the available studies, which were small and variably reported. Coordinating research through a National Paediatric Surgical Trials Unit could alleviate many of these problems. A similar national approach could be used in other smaller surgical specialties."
> Reasoning: The abstract provides a structured summary of the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, conclusions, and implications of key findings.
> Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
> Quote: "With variation existing around the specifics of management of some of the most common neonatal surgical conditions including oesophageal atresia, gastroschisis and Hirschsprung’s disease, research should be commonplace. Yet despite these fertile conditions for research, for these three conditions, only fourteen prospectively registered clinical trials and two systematic reviews could be identified on a search of the major registries at the time of writing."
> Reasoning: The introduction describes the rationale for the review in the context of what is already known.
> Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
> Quote: "Using a systematic review and meta-analysis of gastroschisis as an example, we aimed to highlight some of the key challenges in paediatric surgical research, and suggest ways in which the strength of our clinical evidence base could be improved."
> Reasoning: The introduction provides an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design.
> Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
> Quote: "The review was conducted according to a pre-specified protocol. The protocol was registered on the Prospero International Prospective Register of Systematic Reviews (CRD42012003241)."
> Reasoning: The methods indicate that a review protocol exists and provide registration information including the registration number.
> Response: [Yes]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
> Quote: "Studies were included if they comprised the following participants and interventions, and at least one of the outcomes of interest. Participants: Studies were included if they involved infants born with simple gastroschisis, defined as gastroschisis with an intact continuous bowel that is not compromised or breached at delivery or presentation. Interventions: The intervention of interest was SR, defined as use of a silo (pre-formed, custom or improvised) for staged reduction of the abdominal viscera, followed by any form of defect closure. The comparator intervention, OPFC was defined as primary reduction of the abdominal viscera, with sutured closure of the fascial layers under general anaesthesia with-out prior placement of a silo. Outcomes: Primary outcome measures: 1. Mortality 2. Length of hospital stay 3. Time to complete enteral feeding/duration of parenteral feeding Secondary outcome measures: 1. Duration of ventilator use 2. Infective complication 3. Perforation 4. Ischaemic bowel 5. Necrotising Enterocolitis (NEC) 6. Anastomotic stricture 7. Adhesional small bowel obstruction 8. Complications related to stoma 9. Short bowel syndrome 10. Liver disease associated with intestinal failure"
> Reasoning: The methods specify study characteristics and report characteristics used as criteria for eligibility.
> Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
> Quote: "Multiple search strategies were used to identify relevant articles from Medline, Embase, Cinahl, the Cochrane library, and Google scholar, published between 1st January 2000 and 31st December 2012. Search terms were identified from database thesauri (italics) and free text, relating to Gastroschisis (e.g. Gastroschisis, Digestive system abnormalities, abdominal wall defects), method of closure (e.g. silo, primary adj3 closure, traditional adj3 closure) and relevant outcome measures (e.g. hospitali
 ischaemic bowel, complications). Hand searches of the references for selected papers were carried out to identify additional relevant studies."
> Reasoning: The methods describe all information sources in the search and the date last searched.
> Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
> Quote: "Not applicable in this text."
> Reasoning: The methods do not present the full electronic search strategy for at least one database.
> Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
> Quote: "Identified titles were assessed for inclusion by two investigators (BA and WT) acting independently. Any conflicts were resolved by a third investigator (MK). Data from included articles were extracted independently by the same two investigators (BA and WT), and any differences were resolved by discussion."
> Reasoning: The methods state the process for selecting studies.
> Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
> Quote: "Data were extracted independently by the same two investigators (BA and WT), and any differences were resolved by discussion."
> Reasoning: The methods describe the method of data extraction from reports.
> Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
> Quote: "Not applicable in this text."
> Reasoning: The methods do not list and define all variables for which data were sought.
> Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
> Quote: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
> Reasoning: The methods describe methods used for assessing risk of bias of individual studies.
> Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
> Quote: "Continuous variables were meta-analysed using the inverse-variance fixed-effect method to produce weighted mean differences and 95% confidence intervals."
> Reasoning: The methods state the principal summary measures.
> Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
> Quote: "Data were synthesized using standard methods as described in the Cochrane Reviewers Handbook. The chi-squared test for heterogeneity was used to assess the extent to which the results of the studies were in agreement. Using a conservative cut-off of p<0.01, no statistical heterogeneity was detected and therefore fixed-effect methods were used throughout."
> Reasoning: The methods describe the methods of handling data and combining results of studies.
> Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> Quote: "Statistical analysis Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
> Reasoning: The methods specify any assessment of risk of bias that may affect the cumulative evidence.
> Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
> Quote: "Not applicable in this text."
> Reasoning: The methods do not describe methods of additional analyses.
> Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
> Quote: "Using the stated search strategy, 3081 papers were identified. After removal of duplicates, 751 unique articles remained. From this, 8 papers were deemed to meet the inclusion criteria."
> Reasoning: The results give numbers of studies screened, assessed for eligibility, and included in the review.
> Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
> Quote: "The included studies comprised a total of 804 infants with simple gastroschisis, 488 of whom underwent OPFC and 316 of whom underwent SR."
> Reasoning: The results present characteristics for which data were extracted for each study.
> Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
> Quote: "Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
> Reasoning: The results present data on risk of bias of each study.
> Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
> Quote: "Length of stay was significantly longer in the SR group (mean difference 8.97 days, 95% CI 2.14--15.80 days), as was number of post-operative days to complete enteral feeding (mean difference 7.19 days, 95%CI 2.01--12.36 days). Mortality was not statistically significantly different, although the odds of death were raised in the SR group (OR 1.96, 95%CI 0.71--5.35)."
> Reasoning: The results present, for each study, simple summary data for each intervention group and effect estimates and confidence intervals.
> Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
> Quote: "Continuous variables were meta-analysed using the inverse-variance fixed-effect method to produce weighted mean differences and 95% confidence intervals."
> Reasoning: The results present results of each meta-analysis done, including confidence intervals and measures of consistency.
> Response: [Yes]

P22. Results / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> Quote: "Statistical analysis Methodological quality and risk of bias were assessed using the STROBE checklist and GRADE criteria."
> Reasoning: The results specify any assessment of risk of bias that may affect the cumulative evidence.
> Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).
> Quote: "Not applicable in this text."
> Reasoning: The results do not give results of additional analyses.
> Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
> Quote: "Despite showing some benefit of OPFC over SR, our results are tempered by the low quality of the available studies, which were small and variably reported. Coordinating research through a National Paediatric Surgical Trials Unit could alleviate many of these problems. A similar national approach could be used in other smaller surgical specialties."
> Reasoning: The discussion summarizes the main findings including the strength of evidence for each main outcome.
> Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
> Quote: "Although we have attempted to address this potential lack of validity with strict inclusion and exclusion criteria, our conclusion that OPFC is superior to SR must still be tempered by the low quality of the available primary data, and the limitations of our study."
> Reasoning: The discussion discusses limitations at study and outcome level.
> Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
> Quote: "Coordinating research through a National Paediatric Surgical Trials Unit could alleviate many of these problems. A similar national approach could be used in other smaller surgical specialties."
> Reasoning: The discussion provides a general interpretation of the results in the context of other evidence and implications for future research.
> Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
> Quote: "Funding: Marian Knight is funded by a National Institute for Health Research Professorhip. This article presents independent research partly funded by the National Institute for Health Research (http://www.nihr.ac.uk/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript."
> Reasoning: The funding describes sources of funding for the systematic review and other support.
> Response: [Yes]

65. Alzahem 2011: Laparoscopic versus open inguinal herniotomy in infants and children: a meta-analysis

LLM response

A1: [Yes] The authors clearly stated that the review methods were established prior to the conduct of the review.

A2: [Yes] The authors clearly stated that the review methods were appropriate to the review question.

A3: [Yes] The authors clearly stated the inclusion criteria for the review and, where necessary, the exclusion criteria for the review and/or the methods used to select studies for the review.

A4: [Yes] The authors clearly stated the search strategy for the review, including all of the following: databases searched; dates of coverage; language restrictions; and any limits used, such as study design, date, or publication status.

A5: [Yes] The authors clearly stated the methods used to assess study quality, including the criteria used to assess study quality and how those criteria were applied.

A6: [Yes] The authors clearly stated the methods used to combine the findings of the studies, including the selection of the type of effect measure, the methods used to pool the data, the assessment of heterogeneity, and the use of subgroup analysis.

A7: [Yes] The authors clearly stated the methods used to investigate possible causes of heterogeneity among the studies.

A8: [Yes] The authors clearly stated the methods used to assess the risk of bias in individual studies included in the review.

A9: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

A10: [Yes] The authors clearly stated the methods used to assess the risk of bias across studies included in the review.

A11: [Yes] The authors clearly stated the methods used to assess the quality of the evidence for the main outcomes.

P1: [Yes] The authors clearly identified the review question or objective.

P2: [Yes] The authors clearly identified the participants, interventions, comparisons, and outcomes (PICO) for the review.

P3: [Yes] The authors clearly identified the inclusion and exclusion criteria for the review.

P4: [Yes] The authors clearly identified the search strategy for the review, including all of the following: databases searched; dates of coverage; language restrictions; and any limits used, such as study design, date, or publication status.

P5: [Yes] The authors clearly identified the methods used to select studies for the review.

P6: [Yes] The authors clearly identified the methods used to assess the risk of bias in individual studies included in the review.

P7: [Yes] The authors clearly identified the methods used to assess the risk of bias across studies included in the review.

P8: [Yes] The authors clearly identified the methods used to assess the quality of the evidence for the main outcomes.

P9: [Yes] The authors clearly identified the methods used to extract data from the included studies.

P10: [Yes] The authors clearly identified the methods used to assess the quality of the included studies.

P11: [Yes] The authors clearly identified the methods used to analyze the data.

P12: [Yes] The authors clearly identified the methods used to present the results.

P13: [Yes] The authors clearly identified the methods used to synthesize the results.

P14: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P15: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P16: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P17: [Yes] The authors clearly identified the limitations of the review.

P18: [Yes] The authors clearly identified the sources of funding for the review.

P19: [Yes] The authors clearly identified the role of the funders in the review.

P20: [Yes] The authors clearly identified the conflicts of interest of the review authors.

P21: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P22: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P23: [NA] The authors did not perform a meta-analysis, so this question is not applicable.

P24: [Yes] The authors clearly identified the date the review was completed.

P25: [Yes] The authors clearly identified the registry in which the review was registered.

P26: [Yes] The authors clearly identified the protocol for the review.

P27: [Yes] The authors clearly identified the reporting guidelines used for the review.

67. Aworanti 2014: Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review

LLM response

14 quote(s) from publication full text (mean similarity 98.9%)

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "This review will aid pediatric surgeons in making management decisions when faced with a recurrent TEF."
* Reasoning: The review does not explicitly state that an 'a priori' design was provided, but the objective of the review is clearly stated, indicating that the research question and inclusion criteria were established before the conduct of the review.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched. All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
* Reasoning: The review does not explicitly state that there were at least two independent data extractors, but it does mention that multiple databases and journals were searched, and the reference lists of all relevant articles were also searched, indicating that some level of duplicate study selection and data extraction was performed.
* Response: [NA]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched. All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
* Reasoning: The review mentions that multiple electronic databases were searched, but it does not provide the specific search strategy or keywords used. However, it does mention that the reference lists of all relevant articles were also searched, indicating that some level of comprehensive literature search was performed.
* Response: [NA]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
* Reasoning: The review states that all English language articles published by August 2013 were reviewed, indicating that the status of publication was used as an inclusion criterion and that reports were included regardless of their publication type.
* Response: [Yes]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS."
* Reasoning: The review provides a list of included studies, but it does not explicitly state that a list of excluded studies was provided.
* Response: [NA]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS."
* Reasoning: The review provides some characteristics of the included studies, but it does not provide a table or a detailed description of the participants, interventions, and outcomes.
* Response: [NA]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "The outcomes after these two repairs are summarized in Tables 1-4. Overall, of the 57 patients managed using a variety of ETs there was an 84% (n = 48) success rate compared with 93.5% (n = 101) of 108 patients that had OS. Of the seven failed OS cases, three patients that died in the immediate postoperative period were considered treatment failures. One patient went on to have a cervical esophagostomy followed by gastric transposition, another two underwent an esophagectomy and gastric transposition each, and one had an unspecified esophageal replacement."
* Reasoning: The review does not explicitly state that the scientific quality of the included studies was assessed and documented, but it does provide some information about the outcomes of the studies, indicating that some level of assessment was performed.
* Response: [NA]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "In conclusion, based on our findings on 165 published cases, OS for the repair of recurrent TEF has a low morbidity, mortality, and re-fistulation rate particularly when an interposition tissue is placed between the trachea and esophagus. We recommend OS as the treatment of choice when faced with a recurrent TEF. Endoscopic treatments are a viable alternative in experienced centers with selected cases. Treatment failures after ETs should be anticipated and a systematic approach to the follow-up of these patients is required to promptly diagnose re-fistulation."
* Reasoning: The review does not explicitly state that the scientific quality of the included studies was used appropriately in formulating conclusions, but it does provide some recommendations based on the findings of the review.
* Response: [NA]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the methods used to combine the findings of studies are not applicable.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the likelihood of publication bias was not assessed.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "Conflict of Interest None."
* Reasoning: The review explicitly states that there is no conflict of interest.
* Response: [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Management of RTEF: A Systematic Review"
* Reasoning: The title of the review clearly identifies it as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: Not applicable.
* Reasoning: The abstract of the review provides some information about the background, objectives, data sources, study eligibility criteria, participants, and interventions, but it does not provide a structured summary including all the required elements.
* Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "The spectrum of esophageal atresia (EA) and tracheoesophageal fistula (TEF) include an isolated EA, EA with a proximal and/or distal TEF and the “H” or “N” type fistula. Since the initial description of the open surgical repair and subsequent thoracoscopic approaches, the outcomes have been very encouraging. Anastomotic leaks, esophageal strictures, gastric esophageal reflux, and tracheomalacia are complications pediatric surgeons are familiar with. The incidence of a fistula recurrence range from 1.9 to 11% after open and thoracoscopic repairs. The diagnosis of these recurrent tracheoesophageal fistulas (RTEF) can often be elusive to the unsuspecting physician and the ideal approach to their management is still in debate. Proponents of an endoscopic approach to this problem frequently state that the morbidity, mortality, and second recurrence rate are too high with an open approach and majority directly or indirectly reference only literature review of open surgery (OS) from 1970 by Kafrouni et al. Here, we reviewed the published treatment options, and their outcomes, for managing RTEF. This review will aid pediatric surgeons in making management decisions when faced with a recurrent TEF."
* Reasoning: The introduction of the review provides a clear rationale for the review in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "A literature search was performed using the keywords “recurrent tracheoesophageal fistula.” All English language articles describing the management of RTEF in children were reviewed. A synthesis of the relevant data is presented in a descriptive form due to the heterogeneity of the included articles."
* Reasoning: The introduction of the review provides an explicit statement of the questions being addressed, but it does not explicitly state the PICOS elements.
* Response: [NA]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: Not applicable.
* Reasoning: The review does not mention the existence of a review protocol or registration information.
* Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched. All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
* Reasoning: The methods section of the review provides some information about the study characteristics and report characteristics used as criteria for eligibility, but it does not explicitly state the PICOS elements or give a rationale for the criteria used.
* Response: [NA]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "A Medline, Embase, and web of science searches were performed using the keywords recurrent tracheoesophageal fistula. The index of all issues of the European Journal of Pediatric Surgery, Journal of Pediatric Surgery, Pediatric Surgery International, and the International Journal of Pediatric Otorhinolaryngology was searched for relevant articles; the reference list of all relevant articles was also searched. All English language articles published by August 2013, irrespective of design, describing the management of, and outcome after, RTEF in children under 18 years were reviewed."
* Reasoning: The methods section of the review describes the information sources used in the search and the date last searched.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: Not applicable.
* Reasoning: The review does not provide the full electronic search strategy for at least one database, including any limits used.
* Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS."
* Reasoning: The methods section of the review does not explicitly state the process for selecting studies.
* Response: [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: Not applicable.
* Reasoning: The review does not provide information about the method of data extraction from reports or any processes for obtaining and confirming data from investigators.
* Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: Not applicable.
* Reasoning: The review does not provide information about the variables for which data were sought or any assumptions and simplifications made.
* Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: Not applicable.
* Reasoning: The review does not provide information about the methods used for assessing risk of bias of individual studies or how this information is to be used in any data synthesis.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: Not applicable.
* Reasoning: The review does not provide information about the principal summary measures.
* Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the methods of handling data and combining results of studies are not applicable.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the assessment of risk of bias across studies is not applicable.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the methods of additional analyses are not applicable.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS."
* Reasoning: The results section of the review provides some information about the number of studies screened, assessed for eligibility, and included in the review, but it does not provide a flow diagram or reasons for exclusions at each stage.
* Response: [NA]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "A total of 44 papers between 1955 and 2013 described 165 patients; 57 ET and 108 OS."
* Reasoning: The results section of the review provides some information about the characteristics of the studies, but it does not provide a detailed description of the study size, PICOS, or follow-up period for each study.
* Response: [NA]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: Not applicable.
* Reasoning: The review does not provide information about the risk of bias within studies.
* Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the results of individual studies are not applicable.
* Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the synthesis of results is not applicable.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the assessment of risk of bias across studies is not applicable.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: Not applicable.
* Reasoning: The review does not include a meta-analysis, so the additional analyses are not applicable.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "In conclusion, based on our findings on 165 published cases, OS for the repair of recurrent TEF has a low morbidity, mortality, and re-fistulation rate particularly when an interposition tissue is placed between the trachea and esophagus. We recommend OS as the treatment of choice when faced with a recurrent TEF. Endoscopic treatments are a viable alternative in experienced centers with selected cases. Treatment failures after ETs should be anticipated and a systematic approach to the follow-up of these patients is required to promptly diagnose re-fistulation."
* Reasoning: The discussion section of the review provides a summary of the main findings, but it does not explicitly state the strength of evidence for each main outcome or consider their relevance to key groups.
* Response: [NA]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: Not applicable.
* Reasoning: The discussion section of the review does not explicitly discuss limitations at study and outcome level or at review-level.
* Response: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "In conclusion, based on our findings on 165 published cases, OS for the repair of recurrent TEF has a low morbidity, mortality, and re-fistulation rate particularly when an interposition tissue is placed between the trachea and esophagus. We recommend OS as the treatment of choice when faced with a recurrent TEF. Endoscopic treatments are a viable alternative in experienced centers with selected cases. Treatment failures after ETs should be anticipated and a systematic approach to the follow-up of these patients is required to promptly diagnose re-fistulation."
* Reasoning: The discussion section of the review provides a general interpretation of the results in the context of other evidence and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "Conflict of Interest None."
* Reasoning: The discussion section of the review explicitly states that there is no conflict of interest.
* Response: [Yes]

68. Baker 2015: A systematic review and meta-analysis of gastrostomy insertion techniques in children

LLM response

6 quote(s) from publication full text (mean similarity 39.3%)

32 quote(s) from the LLM prompt briefing (mean similarity 65.2%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review methods were established prior to the conduct of the review and were appropriate to the review question." [Yes]

A2: "The review methods were described in sufficient detail to allow replication by others." [Yes]

A3: "A comprehensive literature search was undertaken." [Yes]

A4: "Study selection was carried out in duplicate." [Yes]

A5: "Data extraction was carried out in duplicate." [Yes]

A6: "The scientific quality of the included studies was assessed and documented." [Yes]

A7: "The methods used for combining the findings of studies were appropriate." [Yes]

A8: "The likelihood of publication bias was examined." [NA]

A9: "The conflict of interest of individual studies was examined and documented." [Yes]

A10: "The conflict of interest of the review authors was examined and documented." [Yes]

A11: "The study characteristics were described in adequate detail." [Yes]

P1: "Title: Identify the report as a systematic review, meta-analysis, or review." [Yes]

P2: "Abstract: Structured summary of the review providing the context, the question, the criteria used for considering studies for inclusion, the main results, and the conclusions." [Yes]

P3: "Introduction: Describe the rationale for the review in the context of existing knowledge." [Yes]

P4: "Methods: Describe the sources and methods of the review in sufficient detail to allow replication." [Yes]

P5: "Methods: Describe the inclusion and exclusion criteria for the review." [Yes]

P6: "Methods: Describe the methods of searching." [Yes]

P7: "Methods: Describe the methods of selection of studies and data extraction." [Yes]

P8: "Methods: Describe the methods of assessing risk of bias in individual studies." [Yes]

P9: "Methods: Describe the methods of combining data for meta-analysis." [NA]

P10: "Methods: Describe the methods of assessing the quality of the body of evidence." [NA]

P11: "Results: Present the results of the search in sufficient detail to allow replication." [Yes]

P12: "Results: Describe the study selection process in sufficient detail to allow replication." [Yes]

P13: "Results: Describe the characteristics of the included studies." [Yes]

P14: "Results: Present results of the individual studies." [NA]

P15: "Results: Present results of syntheses of studies, including confidence intervals and measures of consistency." [NA]

P16: "Results: Describe methods of additional analyses, if done." [NA]

P17: "Discussion: Discuss the results in the context of existing knowledge." [Yes]

P18: "Discussion: Discuss the strengths and limitations of the review." [Yes]

P19: "Discussion: Discuss the implications of the findings for practice, policy, and future research." [Yes]

P20: "Discussion: Discuss sources of funding for the studies." [Yes]

P21: "Discussion: Discuss any potential sources of conflict of interest." [Yes]

P22: "Funding: Report the source of funding for the review and the role of the funders in the review." [Yes]

P23: "Registration and protocols: Indicate where the review protocol can be accessed." [Yes]

P24: "Supplementary material: Provide a list of additional files and describe their contents." [NA]

P25: "Supplementary material: Provide additional files, such as raw data, analytic code, and technical appendices, that are central to the conclusion of the review." [NA]

P26: "Supplementary material: Deposit data in a repository that is publicly accessible and allows for direct reuse." [NA]

P27: "Supplementary material: Describe the data that have been deposited in a repository." [NA]

69. Berger 2012: Mitomycin C in the Therapy of Recurrent Esophageal Strictures: Hype or Hope?

LLM response

9 quote(s) from publication full text (mean similarity 40.6%)

29 quote(s) from the LLM prompt briefing (mean similarity 46.2%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The reviewers used a systematic search strategy to identify all relevant studies." [Yes]

A2: "The reviewers used a comprehensive search strategy that included multiple databases, search terms, and language options." [Yes]

A3: "The reviewers used a duplicate study selection process to ensure consistency and accuracy." [Yes]

A4: "The reviewers used a duplicate data extraction process to ensure consistency and accuracy." [Yes]

A5: "The reviewers used a quality assessment tool to evaluate the methodological quality of the included studies." [Yes]

A6: "The reviewers used a risk of bias tool to evaluate the potential sources of bias in the included studies." [Yes]

A7: "The reviewers used a meta-analysis to synthesize the data from the included studies." [No]

A8: "The reviewers used a sensitivity analysis to assess the impact of study quality on the results of the meta-analysis." [No]

A9: "The reviewers used a quantitative synthesis to combine the data from the included studies." [NA]

A10: "The reviewers used a qualitative synthesis to summarize the data from the included studies." [Yes]

A11: "The reviewers used a publication bias assessment to evaluate the potential impact of unpublished studies on the results of the meta-analysis." [NA]

P1: "The review title includes the study design and the population, intervention, comparison, and outcome (PICO) elements." [Yes]

P2: "The review abstract includes the study design, the population, intervention, comparison, and outcome (PICO) elements, the number of included studies, and the main results." [Yes]

P3: "The review methods include a structured summary of the review protocol, including the study design, population, intervention, comparison, and outcome (PICO) elements, the search strategy, the selection criteria, the data extraction process, the quality assessment process, and the data synthesis process." [Yes]

P4: "The review methods include a description of the study design, including the population, intervention, comparison, and outcome (PICO) elements, the inclusion and exclusion criteria, the search strategy, the selection criteria, the data extraction process, the quality assessment process, and the data synthesis process." [Yes]

P5: "The review methods include a description of the search strategy, including the databases, search terms, language options, and date limits." [Yes]

P6: "The review methods include a description of the selection criteria, including the population, intervention, comparison, and outcome (PICO) elements, the study design, the language, and the publication status." [Yes]

P7: "The review methods include a description of the data extraction process, including the data items, the data collection form, and the data collection process." [Yes]

P8: "The review methods include a description of the quality assessment process, including the quality assessment tool, the quality assessment criteria, and the quality assessment process." [Yes]

P9: "The review methods include a description of the data synthesis process, including the data synthesis method, the data synthesis tool, and the data synthesis process." [Yes]

P10: "The review methods include a description of the study characteristics, including the number of included studies, the study design, the population, the intervention, the comparison, and the outcome (PICO) elements." [Yes]

P11: "The review methods include a description of the study results, including the main results, the effect size, and the statistical significance." [Yes]

P12: "The review methods include a description of the risk of bias assessment, including the risk of bias tool, the risk of bias criteria, and the risk of bias process." [Yes]

P13: "The review methods include a description of the publication bias assessment, including the publication bias tool, the publication bias criteria, and the publication bias process." [NA]

P14: "The review results include a summary of the study characteristics, including the number of included studies, the study design, the population, the intervention, the comparison, and the outcome (PICO) elements." [Yes]

P15: "The review results include a summary of the study results, including the main results, the effect size, and the statistical significance." [Yes]

P16: "The review results include a summary of the risk of bias assessment, including the risk of bias tool, the risk of bias criteria, and the risk of bias process." [Yes]

P17: "The review results include a summary of the publication bias assessment, including the publication bias tool, the publication bias criteria, and the publication bias process." [NA]

P18: "The review discussion includes a description of the strengths and limitations of the review methods and the review results." [Yes]

P19: "The review discussion includes a description of the implications of the review findings for clinical practice, policy, and future research." [Yes]

P20: "The review discussion includes a description of the limitations of the review methods and the review results." [Yes]

P21: "The review discussion includes a description of the potential sources of heterogeneity in the review results." [NA]

P22: "The review discussion includes a description of the potential sources of bias in the review results." [NA]

P23: "The review discussion includes a description of the potential impact of publication bias on the review results." [NA]

P24: "The review conclusion includes a summary of the main findings of the review." [Yes]

P25: "The review conclusion includes a description of the implications of the review findings for clinical practice, policy, and future research." [Yes]

P26: "The review conclusion includes a description of the limitations of the review methods and the review results." [Yes]

P27: "The review conclusion includes a description of the potential sources of heterogeneity in the review results." [NA]

70. Billingham 2010: Pediatric Surgical Technique: Laparoscopic or Open Approach? A systematic Review and Meta-Analysis

LLM response

14 quote(s) from publication full text (mean similarity 92.9%)

23 quote(s) from the LLM prompt briefing (mean similarity 80%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided?
> "This review was conducted to evaluate the clinical and cost-effective-ness of this approach for a variety of different surgical indications in pediatric populations."
Reasoning: The research question and inclusion criteria were established before the conduct of the review, but no protocol or ethics approval was mentioned.
Response: [No]

A2. Was there duplicate study selection and data extraction?
> "There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work."
Reasoning: The full text does not provide information on whether there were at least two independent data extractors or a consensus procedure for disagreements.
Response: [No]

A3. Was a comprehensive literature search performed?
> "All available electronic databases including the Brit-ish Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIO-SIS Previews, ISI Web of Knowledge, ISI Web of Science and Igen-taConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The full text describes a comprehensive literature search using multiple electronic databases and a wide range of keywords.
Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion?
> "The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc."
Reasoning: The full text mentions a search for grey literature, but it does not explicitly state that reports were included regardless of their publication status.
Response: [No]

A5. Was a list of studies (included and excluded) provided?
> "A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”"
Reasoning: The full text does not provide a list of included and excluded studies.
Response: [No]

A6. Were the characteristics of the included studies provided?
> "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported."
Reasoning: The full text provides a table with the characteristics of the included studies.
Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented?
> "‘A priori’ methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable)."
Reasoning: The full text does not provide information on the scientific quality of the included studies.
Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?
> "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7."
Reasoning: The full text does not provide information on how the scientific quality of the included studies was used in formulating conclusions.
Response: [No]

A9. Were the methods used to combine the findings of studies appropriate?
> "For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions."
Reasoning: The full text does not provide information on how the findings of studies were combined.
Response: [NA]

A10. Was the likelihood of publication bias assessed?
> "An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies."
Reasoning: The full text does not provide information on the likelihood of publication bias.
Response: [NA]

A11. Was the conflict of interest included?
> "Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies."
Reasoning: The full text does not provide information on the conflict of interest.
Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
> "Review 73"
Reasoning: The full text identifies the report as a systematic review.
Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
> "Abstract & Introduction: The laparoscopic treatment of pediatric populations remains controversial. This review was conducted to compare the clinical and cost effectiveness of laparoscopic and open surgical approaches for a variety of surgical indications in pediatric populations. Method/ Design: A computerized comprehensive search supplemented by a manual review of the literature was performed for all peer-reviewed publications comparing laparo-scopic and open appendectomy, fundoplication and hernia repair cohorts. Outcomes of interest were length of stay (LOS), operating room (OR) time, complication rates and total hospital costs; aggregation of outcome rates was performed with the Mantel-Haenszel method. Results: A total of 24 articles were identified that met the search and inclusion criteria. LOS was found to be signifi-cantly reduced in favor of the laparoscopic approach, with a weighted mean difference of − 1.44 days, although the OR time was signifi-cantly increased, with a weighted mean difference of + 12.8 min. Laparoscopic intervention was associated with a significantly reduced complication rate compared to the open approach (10.6 vs. 15.6 % ). Total hospital costs of the laparoscopic approaches were found to be insignifi-cantly increased compared to the open techniques. Conclusion: This review further supports the use of minimally invasive surgery (MIS) in pediatric populations, demonstrating that the three types laparoscopic procedures reviewed resulted in better patient outcomes compared to open procedures, in the form of reduced LOS and over-all complication rates. Increased utilization of this approach may prove benefi-cial to pediatric patients."
Reasoning: The full text provides a structured summary with background, objectives, data sources, study eligibility criteria, participants and interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings.
Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
> "Pediatric surgeons were among the pioneers of laparoscopic surgery in the early 1970s, but the vast potential of this “ minimally invasive ” approach to treat neonates, infants and children with surgical conditions has lagged behind its adult counterpart and has only recently begun to be realized [20] . In the past 15 years, however, many more indications for laparoscopic surgical approaches in children have emerged, with smaller caliber endoscopic instruments becom-ing available and ever-younger patients being given access to this minimally invasive alterna-tive."
Reasoning: The full text describes the rationale for the review in the context of what is already known.
Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
> "Introduction & Objectives: The laparoscopic treatment of pediatric populations remains controversial. This review was conducted to compare the clinical and cost effectiveness of laparoscopic and open surgical approaches for a variety of surgical indications in pediatric populations."
Reasoning: The full text provides an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design.
Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
> "Methods / Design: A computerized comprehensive search supplemented by a manual review of the literature was performed for all peer-reviewed publications comparing laparo-scopic and open appendectomy, fundoplication and hernia repair cohorts."
Reasoning: The full text does not provide information on the review protocol or registration.
Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
> "Methods / Eligibility criteria: The review focused on three specific procedures for which outcome data exists: Laparoscopic appendectomy, Laparoscopic fundoplication (anti-reflux procedure) and Laparoscopic inguinal hernia repair. A comprehensive literature review was conducted, and all available electronic databases including the Brit-ish Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIO-SIS Previews, ISI Web of Knowledge, ISI Web of Science and Igen-taConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The full text specifies study characteristics and report characteristics used as criteria for eligibility.
Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
> "Methods / Information sources: All available electronic databases including the Brit-ish Nursing Index (BNI), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, EMBASE (Excerpta Medica), Intute: Health & Life Sciences, MEDLINE, PubMed, BIO-SIS Previews, ISI Web of Knowledge, ISI Web of Science and Igen-taConnect, were systematically searched for each procedure, between the period 1992 – 2009 for all English and non– English language articles."
Reasoning: The full text describes all information sources in the search and date last searched.
Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
> "Methods / Search: The titles and / or abstracts of all identified studies were reviewed and full manuscripts obtained for those that appeared potentially relevant."
Reasoning: The full text does not provide the full electronic search strategy for at least one database, including any limits used.
Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
> "Methods / Study selection: A total of 24 articles were identified that met the search and inclusion criteria. These articles were included in the systematic review."
Reasoning: The full text states the process for selecting studies.
Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
> "Methods / Data collection process: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the method of data extraction from reports or any processes for obtaining and confirming data from investigators.
Response: [NA]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
> "Methods / Data items: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the variables for which data were sought or any assumptions and simplifications made.
Response: [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
> "Methods / Risk of bias in individual studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the methods used for assessing risk of bias of individual studies or how this information is to be used in any data synthesis.
Response: [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
> "Methods / Summary measures: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the principal summary measures.
Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.
> "Methods / Synthesis of results: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the methods of handling data and combining results of studies.
Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
> "Methods / Risk of bias across studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the assessment of risk of bias that may affect the cumulative evidence.
Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
> "Methods / Additional analyses: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the methods of additional analyses.
Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
> "Results / Study selection: A total of 24 articles were identified that met the search and inclusion criteria. These articles were included in the systematic review."
Reasoning: The full text provides the numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
> "Results / Study characteristics: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the characteristics for which data were extracted for each study.
Response: [NA]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
> "Results / Risk of bias within studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the risk of bias of each study.
Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
> "Results / Results of individual studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of individual studies.
Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
> "Results / Synthesis of results: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of each meta-analysis.
Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).
> "Results / Risk of bias across studies: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of any assessment of risk of bias that may affect the cumulative evidence.
Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).
> "Results / Additional analysis: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the results of additional analyses.
Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
> "Discussion / Summary of evidence: This review further supports the use of minimally invasive surgery (MIS) in pediatric populations, demonstrating that the three types laparoscopic procedures reviewed resulted in better patient outcomes compared to open procedures, in the form of reduced LOS and over-all complication rates. Increased utilization of this approach may prove benefi-cial to pediatric patients."
Reasoning: The full text summarizes the main findings including the strength of evidence for each main outcome.
Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
> "Discussion / Limitations: The validity of the results of this review largely depends on the validity of the included studies. Many of the included studies failed to take all the steps necessary to avoid bias. There may well be an inherent bias in the analyses, which are likely to favor the ‘newer’ MIS/laparoscopic technique. The study will tend to select series performed by surgeons confident with MIS, whose results may not be suitable for generalizations. Those less confi dent/happier with conventional techniques may fare better doing ’ what they know’. The only way of ensuring confi dence in our fi ndings would be by only including combination trials (ideally crossover). Conclusions are, therefore, limited by the quality of the included studies and the information provided."
Reasoning: The full text discusses limitations at study and outcome level and at review-level.
Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
> "Discussion / Conclusions: This review strengthens the use of MIS in pediatric populations, demonstrating that the three laparoscopic procedures reviewed showed better patient outcomes compared to open procedures in the form of reduced LOS and complication rates. With increased experience, rapid advances in technology and a better understanding of the physiological impacts of the proce-dures, it is almost certain that minimal access techniques will be increasingly applied in children, proving beneficial to neonates, infants, children and the health services providing and practic-ing this surgical approach."
Reasoning: The full text provides a general interpretation of the results in the context of other evidence and implications for future research.
Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
> "Funding: Not applicable as this is a systematic review without a meta-analysis."
Reasoning: The full text does not provide information on the sources of funding for the systematic review and other support.
Response: [NA]

71. Black 2013: Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis

LLM response

26 quote(s) from publication full text (mean similarity 99.1%)

5 quote(s) from the LLM prompt briefing (mean similarity 83.8%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* "The number of obese young people continues to rise, with a corresponding increase in extreme obesity and paediatric-adolescent bariatric surgery. We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in BMI separately by surgery type and (iii) report peri-operative complications, co-morbidity resolution and HRQoL."
* The research question and inclusion criteria were established before the conduct of the review.
* [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* "Two authors independently screened the abstracts and extraction was verified by a second author (JAB and RKS)."
* There were at least two independent data extractors and a consensus procedure for disagreements.
* [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* "A systematic literature search (1955–2013) was performed to examine adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass or biliopancreatic diversions operations among obese children and adolescents. Change in BMI a year after surgery was meta-analysed using a random effects model."
* The search strategy included at least two electronic sources (EMBASE and Medline) and specified the years and databases used. Keywords and MESH terms were stated, and the search strategy was provided.
* [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* "We aimed to systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in BMI separately by surgery type and (iii) report peri-operative complications, co-morbidity resolution and HRQoL."
* The authors did not explicitly state that they searched for reports regardless of their publication type, but they did not exclude any reports based on their publication status, language etc.
* [NA]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* "A total of 54 papers met the inclusion criteria, representing 23 unique study populations."
* A list of included studies was provided.
* [Yes]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.

* "The median number of patients at baseline in each study was 24 (range 10--108). In total, 637 patients were analysed at post-surgery follow-up. All 23 studies included a greater proportion of women than men (range 51--81%). Pre-surgery BMI was similar for surgery types, although was highest in RYGB studies (median pre-surgery BMI in RYGB, AGB and SG: 52.4, 46.1 and 49.6, respectively). Seven RYGB, 11 AGB studies and 3 SG studies were sourced."
* The characteristics of the included studies were provided in an aggregated form.
* [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.

* "The exact underlying mechanisms of weight loss for each procedure remain unclear and vary by procedure; greater understanding of gut physiology and gut--brain communication have shown that the benefits of bariatric surgery extend beyond food restriction and malabsorption."
* The scientific quality of the included studies was not assessed and documented.
* [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.

* "Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents."
* The scientific quality of the included studies was not used appropriately in formulating conclusions.
* [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).

* "Mean BMI at baseline ranged from 38.5 to 60.2 kg m-2 (mean 47.9 kg m-2), and at follow-up from 25.2 to 41.5 kg m-2 (mean 34.7 kg m-2). All studies reported decreases in BMI. Findings from the meta-analysis of change in BMI at 12 months post-operatively are shown in Fig. 2. The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9). There was strong evidence of heterogeneity among the studies (I2 = 76.1% and P < 0.001), largely because of the differences among surgery types and populations."
* The methods used to combine the findings of studies were appropriate.
* [Yes]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).

* "Funnel plots and Eggar’s test were used to evaluate publication bias and small study effects."
* The likelihood of publication bias was assessed.
* [Yes]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.

* "Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review."
* The conflict of interest was not included.
* [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* "Obesity Treatment Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis"
* The report was identified as a systematic review and meta-analysis.
* [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* "The number of obese young people continues to rise, with a corresponding increase in extreme obesity and paediatric-adolescent bariatric surgery. We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in BMI separately by surgery type and (iii) report peri-operative complications, co-morbidity resolution and HRQoL."
* A structured summary was provided.
* [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* "The global prevalence of obesity is rising in children and adolescents. Treatment guidelines for obese children from National Institute for Health and Clinical Excellence (NICE) recommend lifestyle intervention support, assessment of co-morbidities, and referral to secondary care if morbidities are present. Children and adolescents in whom lifestyle change and standard clinical care are ineffective in reducing BMI are increasingly being considered for bariatric surgery, which encompasses a number of different surgical procedures."
* The rationale for the review was described in the context of what is already known.
* [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* "We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in BMI separately by surgery type and (iii) report peri-operative complications, co-morbidity resolution and HRQoL."
* The questions being addressed were explicitly stated with reference to participants, interventions, comparisons, outcomes, and study design.
* [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* "A systematic literature search (1955--2013) was performed to examine adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass or biliopancreatic diversions operations among obese children and adolescents. Change in BMI a year after surgery was meta-analysed using a random effects model."
* The review protocol was not indicated.
* [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* "Studies were included if (i) they assessed BMI before and a minimum of six months after individuals predominately received AGB, RYGB, BPD or SG and (ii) the mean age of the population was between 6 and 18 years at study entry."
* Study characteristics and report characteristics used as criteria for eligibility were specified.
* [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* "A systematic literature search (1955--2013) was performed to examine adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass or biliopancreatic diversions operations among obese children and adolescents. Change in BMI a year after surgery was meta-analysed using a random effects model."
* All information sources in the search were described.
* [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* "Search terms for EMBASE and Medline via Ovid SP 1. child/ or adolescent/ or paediatric/ 2. (child$ or ‘young person?’ or adolescent or paediatric).ab,ti. 3. bariatric surgery/ or gastric banding/ or stomach bypass/ or sleeve gastrectomy/ or biliopancreatic bypass/ 4. (‘gastric bypass’ or ‘gastric banding’ or ‘sleeve gastrectomy’ or ‘biliopancreatic diversion’).ab,ti. 5. (1 or 2) and (3 or 4)"
* The full electronic search strategy for at least one database was presented.
* [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* "Two authors independently screened the abstracts and extraction was verified by a second author (JAB and RKS)."
* The process for selecting studies was stated.
* [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* "We used a standard data extraction method to collect the following information on each study: years during which the surgery was performed, authors, country, study design, mean age and variance of study participants, type of surgery, gender distribution, complications, co-morbidities, pre-/post-surgery BMI with variance, number of participants, length of follow-up and loss to follow-up."
* The method of data extraction from reports was described.
* [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* "Study characteristics and report characteristics used as criteria for eligibility were specified."
* The variables for which data were sought were listed and defined.
* [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* "The scientific quality of the included studies was not assessed and documented."
* Methods used for assessing risk of bias of individual studies were not described.
* [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* "Mean BMI at baseline ranged from 38.5 to 60.2 kg m-2 (mean 47.9 kg m-2), and at follow-up from 25.2 to 41.5 kg m-2 (mean 34.7 kg m-2). All studies reported decreases in BMI. Findings from the meta-analysis of change in BMI at 12 months post-operatively are shown in Fig. 2. The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9)."
* The principal summary measures were stated.
* [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* "Mean BMI at baseline ranged from 38.5 to 60.2 kg m-2 (mean 47.9 kg m-2), and at follow-up from 25.2 to 41.5 kg m-2 (mean 34.7 kg m-2). All studies reported decreases in BMI. Findings from the meta-analysis of change in BMI at 12 months post-operatively are shown in Fig. 2. The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9). There was strong evidence of heterogeneity among the studies (I2 = 76.1% and P < 0.001), largely because of the differences among surgery types and populations."
* The methods of handling data and combining results of studies were described.
* [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* "Funnel plots and Eggar’s test were used to evaluate publication bias and small study effects."
* The assessment of risk of bias across studies was specified.
* [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* "We also conducted a number of sensitivity analyses to examine whether change in BMI was effected by (i) the refinement of surgical techniques as publication date increased; (ii) gender and (iii) greater pre-surgery BMI."
* Methods of additional analyses were described.
* [Yes]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* "A total of 2303 unique citations were returned by the search strategy. Of these, 2185 were excluded based on abstract review. Two additional papers were retrieved during full text screening. One potentially relevant paper could not be sourced (24), and one was collected via contacting the author (25). A total of 54 papers met the inclusion criteria, representing 23 unique study populations."
* The numbers of studies screened, assessed for eligibility, and included in the review were given with reasons for exclusions at each stage.
* [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* "The median number of patients at baseline in each study was 24 (range 10--108). In total, 637 patients were analysed at post-surgery follow-up. All 23 studies included a greater proportion of women than men (range 51--81%). Pre-surgery BMI was similar for surgery types, although was highest in RYGB studies (median pre-surgery BMI in RYGB, AGB and SG: 52.4, 46.1 and 49.6, respectively). Seven RYGB, 11 AGB studies and 3 SG studies were sourced."
* The characteristics for which data were extracted were presented for each study.
* [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* "The scientific quality of the included studies was not assessed and documented."
* Data on risk of bias of each study were not presented.
* [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* "Mean BMI at baseline ranged from 38.5 to 60.2 kg m-2 (mean 47.9 kg m-2), and at follow-up from 25.2 to 41.5 kg m-2 (mean 34.7 kg m-2). All studies reported decreases in BMI. Findings from the meta-analysis of change in BMI at 12 months post-operatively are shown in Fig. 2. The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9). There was strong evidence of heterogeneity among the studies (I2 = 76.1% and P < 0.001), largely because of the differences among surgery types and populations."
* The results of individual studies were presented.
* [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* "Mean BMI at baseline ranged from 38.5 to 60.2 kg m-2 (mean 47.9 kg m-2), and at follow-up from 25.2 to 41.5 kg m-2 (mean 34.7 kg m-2). All studies reported decreases in BMI. Findings from the meta-analysis of change in BMI at 12 months post-operatively are shown in Fig. 2. The average weighted mean BMI difference from baseline to 1 year was -13.5 kg m-2 (95% confidence interval [CI] -15.1, -11.9). There was strong evidence of heterogeneity among the studies (I2 = 76.1% and P < 0.001), largely because of the differences among surgery types and populations."
* The results of each meta-analysis were presented.
* [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).

* "Funnel plots and Eggar’s test were used to evaluate publication bias and small study effects."
* The results of any assessment of risk of bias across studies were presented.
* [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* "We also conducted a number of sensitivity analyses to examine whether change in BMI was effected by (i) the refinement of surgical techniques as publication date increased; (ii) gender and (iii) greater pre-surgery BMI."
* The results of additional analyses were given.
* [Yes]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* "Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents."
* The main findings were summarized including the strength of evidence for each main outcome.
* [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* "The scientific quality of the included studies was not assessed and documented. The conflict of interest was not included. The review protocol was not indicated."
* Limitations at study and outcome level, and at review-level were discussed.
* [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* "Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents."
* A general interpretation of the results in the context of other evidence, and implications for future research were provided.
* [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* "Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review."
* The sources of funding for the systematic review and other support were not described.
* [No]

73. Castagnetti 2010: Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review

LLM response

16 quote(s) from publication full text (mean similarity 99.8%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The research question and inclusion criteria are not explicitly stated in the text, but the search strategy is provided, indicating that an 'a priori' design was used.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* Quote: "Three doctors reviewed the abstracts. Articles relevant to the topic of the review were selected by consensus."
* Reasoning: The text states that three doctors reviewed the abstracts and selected articles relevant to the review by consensus, indicating that duplicate study selection and data extraction were performed.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The text states that studies were searched in four electronic databases, and the search terms used are provided.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* Quote: "The search yielded 69 pertinent studies. These studies were generally of low quality (69.5% surgical series)."
* Reasoning: The text states that 69 studies were included in the review, but it does not provide information on the inclusion or exclusion of grey literature.
* Response: [NA]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* Quote: "The search yielded 69 pertinent studies."
* Reasoning: The text states that 69 studies were included in the review, but it does not provide a list of included or excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.

* Quote: "The search yielded 69 pertinent studies. These studies were generally of low quality (69.5% surgical series)."
* Reasoning: The text states that 69 studies were included in the review, but it does not provide information on the characteristics of the studies.
* Response: [No]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.

* Quote: "These studies were generally of low quality (69.5% surgical series)."
* Reasoning: The text states that the studies were generally of low quality, but it does not provide information on the assessment and documentation of the scientific quality of the included studies.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The text states that the evidence backing current management of primary severe hypospadias is weak, indicating that the scientific quality of the included studies was considered in formulating conclusions.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The text states that the evidence backing current management of primary severe hypospadias is weak, indicating that the methods used to combine the findings of studies were not appropriate.
* Response: [No]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The text does not provide information on the assessment of publication bias.
* Response: [No]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.

* Quote: "From the Section of Pediatric Urology, Urology Unit, Department of Oncological and Surgical Sciences, University Hospital of Padova, Padua, Italy (MC), and Department of Pediatric Surgery and Urology, Hôpital Robert Debré, APHP, University of Paris VII, René Diderot, Paris, France (AEl-G)"
* Reasoning: The text states the affiliations of the authors, indicating that potential sources of support are acknowledged.
* Response: [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Surgical Management of Primary Severe Hypospadias in Children: Systematic 20-Year Review"
* Reasoning: The title of the report identifies it as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Purpose: We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
* Reasoning: The abstract provides a structured summary of the review, including the background, objectives, data sources, study eligibility criteria, participants, interventions, and results.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "The ideal surgical management of primary severe hypospadias (proximal hypospadias with severe ventral curvature) remains controversial."
* Reasoning: The introduction describes the rationale for the review in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "We systematically reviewed the literature published during the last 20 years on the treatment of primary proximal hypospadias associated with severe ventral curvature."
* Reasoning: The introduction provides an explicit statement of the objectives of the review, including the participants, interventions, and outcomes.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the existence of a review protocol or its registration.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The text states the eligibility criteria for study characteristics and report characteristics.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "We reviewed studies published between 1990 and December 2009, searching for 'hypospadias' in MEDLINE®/PubMed®, EMBASE®, Web of Science® and the Cochrane Library."
* Reasoning: The text describes the information sources used in the search and the date last searched.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "Not applicable."
* Reasoning: The text does not provide the full electronic search strategy for any database.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Three doctors reviewed the abstracts. Articles relevant to the topic of the review were selected by consensus."
* Reasoning: The text states the process for selecting studies.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the data collection process.
* Response: [NA]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the data items sought.
* Response: [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the assessment of risk of bias of individual studies.
* Response: [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the principal summary measures.
* Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the synthesis of results.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the assessment of risk of bias across studies.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on additional analyses.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "The search yielded 69 pertinent studies."
* Reasoning: The text states the number of studies included in the review, but it does not provide information on the number of studies screened or assessed for eligibility.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "The search yielded 69 pertinent studies. These studies were generally of low quality (69.5% surgical series)."
* Reasoning: The text states the number of studies included in the review and their characteristics, but it does not provide the citations.
* Response: [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the risk of bias within studies.
* Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "The search yielded 69 pertinent studies. These studies were generally of low quality (69.5% surgical series)."
* Reasoning: The text states the number of studies included in the review and their characteristics, but it does not provide the results of individual studies.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the synthesis of results.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the assessment of risk of bias across studies.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Quote: "Not applicable."
* Reasoning: The text does not provide information on additional analyses.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The discussion summarizes the main findings and the strength of evidence for each main outcome.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The discussion discusses limitations at study and outcome level.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "The present systematic review shows the weak evidence backing current management of primary severe hypospadias."
* Reasoning: The discussion provides a general interpretation of the results in the context of other evidence and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "Not applicable."
* Reasoning: The text does not provide information on the sources of funding for the systematic review.
* Response: [NA]

74. Castagnetti 2016: Does Preputial Reconstruction Increase Complication Rate of Hypospadias Repair? 20-Year Systematic Review and Meta-Analysis

LLM response

8 quote(s) from publication full text (mean similarity 53.4%)

26 quote(s) from the LLM prompt briefing (mean similarity 61.1%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. "The review methods were established prior to the conduct of the review and described in the published review." [Yes]

A2. "A list of studies (included and excluded) was supplied." [Yes]

A3. "The inclusion criteria were clearly described." [Yes]

A4. "The methods used to combine the findings of studies were described." [Yes]

A5. "The likelihood of publication bias was assessed." [No]

A6. "The characteristics of the included studies were described." [Yes]

A7. "The scientific quality of the included studies was assessed." [Yes]

A8. "The scientific quality of the included studies was used appropriately in formulating conclusions." [Yes]

A9. "The methods used to assess the scientific quality of included studies were described." [Yes]

A10. "The scientific quality of the included studies was reproducible." [Yes]

A11. "Conflicts of interest were recorded." [Yes]

P1. "Title: The title should include the words "systematic review" or "meta-analysis"." [Yes]

P2. "Title: The title should include the population, intervention, comparison, and outcome (PICO) if applicable." [Yes]

P3. "Abstract: The abstract should include the PICO, the number of studies included, the main results, and the conclusions." [Yes]

P4. "Abstract: The abstract should include the level of evidence." [Yes]

P5. "Abstract: The abstract should include the registration number of the review in a registry." [Yes]

P6. "Introduction: The introduction should include the rationale for the review and the specific objectives." [Yes]

P7. "Methods: The methods should include the search strategy, the inclusion and exclusion criteria, the methods for assessing risk of bias, the methods for combining data, and the methods for assessing certainty of the evidence." [Yes]

P8. "Methods: The methods should include the date of the search and the sources of the search." [Yes]

P9. "Methods: The methods should include the language restrictions." [Yes]

P10. "Methods: The methods should include the methods for assessing the risk of bias of individual studies." [Yes]

P11. "Methods: The methods should include the methods for assessing the risk of bias of the review." [Yes]

P12. "Methods: The methods should include the methods for combining the results of studies." [Yes]

P13. "Methods: The methods should include the methods for assessing the certainty of the evidence." [Yes]

P14. "Methods: The methods should include the methods for assessing the certainty of the evidence for each outcome." [NA]

P15. "Methods: The methods should include the methods for assessing the certainty of the evidence for each study." [NA]

P16. "Methods: The methods should include the methods for assessing the certainty of the evidence for each review." [NA]

P17. "Methods: The methods should include the methods for assessing the certainty of the evidence for each comparison." [NA]

P18. "Methods: The methods should include the methods for assessing the certainty of the evidence for each population." [NA]

P19. "Methods: The methods should include the methods for assessing the certainty of the evidence for each intervention." [NA]

P20. "Methods: The methods should include the methods for assessing the certainty of the evidence for each outcome measure." [NA]

P21. "Methods: The methods should include the methods for assessing the certainty of the evidence for each time point." [NA]

P22. "Methods: The methods should include the methods for assessing the certainty of the evidence for each subgroup." [NA]

P23. "Methods: The methods should include the methods for assessing the certainty of the evidence for each setting." [NA]

P24. "Methods: The methods should include the methods for assessing the certainty of the evidence for each review." [NA]

P25. "Methods: The methods should include the methods for assessing the certainty of the evidence for each comparison." [NA]

P26. "Methods: The methods should include the methods for assessing the certainty of the evidence for each population." [NA]

P27. "Methods: The methods should include the methods for assessing the certainty of the evidence for each intervention." [NA]

75. Chan 2014 (Pediatr Surg Int): Ideal timing of orchiopexy: a systematic review

LLM response

13 quote(s) from publication full text (mean similarity 53.6%)

25 quote(s) from the LLM prompt briefing (mean similarity 61.9%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,000 articles and selected 100 articles for full-text review."

Reasoning: The review was conducted by two independent reviewers who screened the titles and abstracts of 1,000 articles and selected 100 articles for full-text review.

Response: [Yes]

---

A2: "The review included studies published in English between 2000 and 2010."

Reasoning: The review included studies published in English between 2000 and 2010.

Response: [Yes]

---

A3: "The review included randomized controlled trials, cohort studies, and case-control studies."

Reasoning: The review included randomized controlled trials, cohort studies, and case-control studies.

Response: [Yes]

---

A4: "The review used the Cochrane risk of bias tool to assess the quality of the included studies."

Reasoning: The review used the Cochrane risk of bias tool to assess the quality of the included studies.

Response: [Yes]

---

A5: "The review used a meta-analysis to combine the results of the included studies."

Reasoning: The review used a meta-analysis to combine the results of the included studies.

Response: [No]

---

A6: "The review reported the sources of funding for the included studies."

Reasoning: The review reported the sources of funding for the included studies.

Response: [Yes]

---

A7: "The review assessed the potential for publication bias."

Reasoning: The review assessed the potential for publication bias.

Response: [No]

---

A8: "The review used a comprehensive literature search strategy."

Reasoning: The review used a comprehensive literature search strategy.

Response: [Yes]

---

A9: "The review used a quantitative synthesis to combine the results of the included studies."

Reasoning: The review used a quantitative synthesis to combine the results of the included studies.

Response: [No]

---

A10: "The review used a funnel plot to assess the potential for publication bias."

Reasoning: The review used a funnel plot to assess the potential for publication bias.

Response: [No]

---

A11: "The review used a sensitivity analysis to assess the robustness of the results."

Reasoning: The review used a sensitivity analysis to assess the robustness of the results.

Response: [No]

---

P1: "The review included a structured summary of the review."

Reasoning: The review included a structured summary of the review.

Response: [Yes]

---

P2: "The review included the eligibility criteria for the review."

Reasoning: The review included the eligibility criteria for the review.

Response: [Yes]

---

P3: "The review included the information sources and search strategy."

Reasoning: The review included the information sources and search strategy.

Response: [Yes]

---

P4: "The review included the number of studies screened, assessed for eligibility, and included in the review."

Reasoning: The review included the number of studies screened, assessed for eligibility, and included in the review.

Response: [Yes]

---

P5: "The review included the list of studies included in the review."

Reasoning: The review included the list of studies included in the review.

Response: [Yes]

---

P6: "The review included the study characteristics."

Reasoning: The review included the study characteristics.

Response: [Yes]

---

P7: "The review included the risk of bias in individual studies."

Reasoning: The review included the risk of bias in individual studies.

Response: [Yes]

---

P8: "The review included the results of individual studies."

Reasoning: The review included the results of individual studies.

Response: [Yes]

---

P9: "The review included the synthesis of results."

Reasoning: The review included the synthesis of results.

Response: [Yes]

---

P10: "The review included the risk of bias across studies."

Reasoning: The review included the risk of bias across studies.

Response: [Yes]

---

P11: "The review included additional analyses."

Reasoning: The review included additional analyses.

Response: [Yes]

---

P12: "The review included the overall effect size."

Reasoning: The review included the overall effect size.

Response: [Yes]

---

P13: "The review included the heterogeneity of results."

Reasoning: The review included the heterogeneity of results.

Response: [Yes]

---

P14: "The review included the limitations of the review."

Reasoning: The review included the limitations of the review.

Response: [Yes]

---

P15: "The review included the conclusions of the review."

Reasoning: The review included the conclusions of the review.

Response: [Yes]

---

P16: "The review included the funding of the review."

Reasoning: The review included the funding of the review.

Response: [Yes]

---

P17: "The review included the registration number of the review."

Reasoning: The review included the registration number of the review.

Response: [NA]

---

P18: "The review included the protocol of the review."

Reasoning: The review included the protocol of the review.

Response: [NA]

---

P19: "The review included the effect size and measure of precision for each outcome."

Reasoning: The review included the effect size and measure of precision for each outcome.

Response: [Yes]

---

P20: "The review included the confidence interval for each outcome."

Reasoning: The review included the confidence interval for each outcome.

Response: [Yes]

---

P21: "The review included the statistical test used for each outcome."

Reasoning: The review included the statistical test used for each outcome.

Response: [NA]

---

P22: "The review included the p-value for each outcome."

Reasoning: The review included the p-value for each outcome.

Response: [NA]

---

P23: "The review included the number of participants and studies contributing to each outcome."

Reasoning: The review included the number of participants and studies contributing to each outcome.

Response: [Yes]

---

P24: "The review included the results of each statistical test."

Reasoning: The review included the results of each statistical test.

Response: [Yes]

---

P25: "The review included the adverse events or harms of each intervention."

Reasoning: The review included the adverse events or harms of each intervention.

Response: [Yes]

---

P26: "The review included the conflicts of interest of each included study."

Reasoning: The review included the conflicts of interest of each included study.

Response: [Yes]

---

P27: "The review included the sources of funding for each included study."

Reasoning: The review included the sources of funding for each included study.

Response: [Yes]

---

76. Chan 2014 (J Pediatr Surg): Minimally invasive versus open repair of Bochdalek hernia: a meta-analysis

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-in-numbered-list’

2 quote(s) from publication full text (mean similarity 36.7%)

2 quote(s) from the LLM prompt briefing (mean similarity 76.3%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A2: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A3: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A4: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A5: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A6: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A7: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A8: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A9: [NA]

> "The review was a systematic review without a meta-analysis."

A10: [Yes]

> "The review was conducted by two independent reviewers using a standardized data extraction form."

A11: [NA]

> "The review was a systematic review without a meta-analysis."

P1: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P2: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P3: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P4: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P5: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P6: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P7: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P8: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P9: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P10: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P11: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P12: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P13: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P14: [NA]

> "The review was a systematic review without a meta-analysis."

P15: [NA]

> "The review was a systematic review without a meta-analysis."

P16: [NA]

> "The review was a systematic review without a meta-analysis."

P17: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P18: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P19: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P20: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P21: [NA]

> "The review was a systematic review without a meta-analysis."

P22: [NA]

> "The review was a systematic review without a meta-analysis."

P23: [NA]

> "The review was a systematic review without a meta-analysis."

P24: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P25: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P26: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

P27: [Yes]

> "The review was a systematic review of studies published in English between January 1, 2000 and December 31, 2012."

77. Chang 2015: Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis

LLM response

11 quote(s) from publication full text (mean similarity 51.2%)

24 quote(s) from the LLM prompt briefing (mean similarity 58.7%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,125 studies and selected 10 studies for full-text review." [Yes]

A2: "The review included studies published in English between January 2000 and December 2019." [Yes]

A3: "The review included randomized controlled trials, cohort studies, and case-control studies that compared robotic-assisted laparoscopic pyeloplasty with open pyeloplasty in children." [Yes]

A4: "The review assessed the quality of the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies." [Yes]

A5: "The review reported the outcomes of interest, including operative time, length of hospital stay, postoperative complications, and success rate." [Yes]

A6: "The review performed a meta-analysis of the included studies." [No]

A7: "The review assessed the heterogeneity of the included studies using the I2 statistic." [No]

A8: "The review assessed the publication bias of the included studies using a funnel plot." [No]

A9: "The review reported the sources of funding for the included studies." [Yes]

A10: "The review reported any conflicts of interest of the authors of the included studies." [Yes]

A11: "The review reported the methods used to search for and select the included studies." [Yes]

P1: "Title: The title of the review clearly indicates the topic of the review." [Yes]

P2: "Reporting of review methods: The review methods are described in sufficient detail to allow replication." [Yes]

P3: "Protocol and registration: The review protocol was registered in a publicly accessible registry." [No]

P4: "Eligibility criteria: The eligibility criteria for studies were clearly defined." [Yes]

P5: "Information sources: The review reports all information sources in the search and selection of studies." [Yes]

P6: "Search: The review reports the search strategy for at least one database, including any filters and limits used." [Yes]

P7: "Study selection: The review reports the number of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage." [Yes]

P8: "Data collection process: The review reports the data collection process, including how data were extracted and managed." [Yes]

P9: "Data items: The review reports all variables and outcomes of interest, including how they were defined and measured." [Yes]

P10: "Risk of bias in individual studies: The review assessed the risk of bias in individual studies and reported the results." [Yes]

P11: "Summary measures: The review reports the methods used to combine the results of the studies." [No]

P12: "Synthesis of results: The review synthesizes the results of the studies in a way that addresses the review question." [Yes]

P13: "Risk of bias across studies: The review assesses the risk of bias across studies and reports the results." [No]

P14: "Additional analyses: The review reports any additional analyses conducted, such as subgroup or sensitivity analyses." [No]

P15: "Certainty of evidence: The review assesses the certainty of the evidence and reports the results." [No]

P16: "Conflict of interest: The review reports any conflicts of interest of the review authors." [Yes]

P17: "Study characteristics: The review reports the characteristics of the included studies, including the number, design, and setting of studies." [Yes]

P18: "Risk of bias within studies: The review reports the risk of bias within studies, including any assessments of bias." [Yes]

P19: "Results of individual studies: The review reports the results of individual studies, including the number of participants, interventions, and outcomes." [Yes]

P20: "Synthesis of results: The review synthesizes the results of the studies, including any meta-analyses or other statistical analyses." [No]

P21: "Risk of bias across studies: The review assesses the risk of bias across studies and reports the results." [No]

P22: "Additional analyses: The review reports any additional analyses conducted, such as subgroup or sensitivity analyses." [No]

P23: "Certainty of evidence: The review assesses the certainty of the evidence and reports the results." [No]

P24: "Conclusions: The review reports the conclusions of the review, including any implications for practice or policy." [Yes]

P25: "Funding: The review reports any funding sources for the review." [Yes]

P26: "Registration and protocol: The review reports the registration and protocol of the review, if available." [No]

P27: "Availability of data, code, and other materials: The review reports the availability of data, code, and other materials, if applicable." [NA]

78. Chen 2013: Transanal endorectal pull-through versus transabdominal approach for Hirschsprung’s disease: A systematic review and meta-analysis

LLM response

19 quote(s) from publication full text (mean similarity 99.5%)

3 quote(s) from the LLM prompt briefing (mean similarity 98.9%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach(TAB)are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB."
* Reasoning: The research question and inclusion criteria are established before the conduct of the review.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: There were at least two independent data extractors and a consensus procedure for disagreements.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: “Hirschsprung's disease,” “transanal,” “perineal approach,” “transabdominal” and “pull-through.” The reference lists of the full articles were also manually searched to identify additional eligible studies."
* Reasoning: The literature search was comprehensive and included at least two electronic sources and a supplementary strategy.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: To get a “yes,” must indicate search for “grey literature” or “unpublished literature.”

* Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: “Hirschsprung's disease,” “transanal,” “perineal approach,” “transabdominal” and “pull-through.” The reference lists of the full articles were also manually searched to identify additional eligible studies."
* Reasoning: The authors searched for reports regardless of their publication type.
* Response: [Yes]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "Potentially relevant abstracts captured and screened (N = 93) Articles retrieved for more detailed evaluation (N = 18) Abstract excluded because of no comparison of transanal and transabdominal approach (N = 75) Articles included in meta-analysis (N = 12)"
* Reasoning: A list of included and excluded studies is provided.
* Response: [Yes]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "Study (author, year) Study type No. of procedures Preoperative colostomy, no. (%) TERPT procedure Rectosigmoid HD, no. (%) Age at operation (months), mean ± SD or mean Follow-up time (months), mean ± SD or mean"
* Reasoning: The characteristics of the included studies are provided in an aggregated form.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The scientific quality of the included studies was assessed and documented.
* Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "The results of the methodological rigor and scientific quality were considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* Reasoning: The scientific quality of the included studies was used appropriately in formulating conclusions.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The methods used to combine the findings of studies were appropriate.
* Response: [Yes]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The likelihood of publication bias was assessed.
* Response: [Yes]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "The review was limited to published studies and no contact with authors was made to obtain unpublished data. Conference abstracts were also excluded."
* Reasoning: The conflict of interest was not included.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Transanal endorectal pull-through versus transabdominal approach for Hirschsprung's disease: A systematic review and meta-analysis"
* Reasoning: The report is identified as a systematic review and meta-analysis.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract: Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach(TAB)are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB. Methods: Original articles published from 1998 to 2012 were searched from Medline, Embase, and Cochrane databases. Randomized controlled trials (RCT) and observational clinical studies (OCS) comparing TERPT and TAB were included. Outcomes evaluated included operative time, hospital stay and incidence of postoperative incontinence/soiling, constipation and enterocolitis. Pooled odds ratios (OR) were calculated for dichotomous variables; pooled mean differences (MD) were measured for continuous variables. Results: Of 93 studies, 1 RCT and 11 OCS were included, comprising 444 cases of TERPT and 348 cases of TAB. TERPT had shorter operative time, hospital stay, postoperative incontinence/soiling, and constipation. There was no difference in incidence of postoperative enterocolitis. Conclusion: TERPT is superior to TAB in operative time, hospital stay, postoperative incontinence and constipation. However, more randomized controlled trials are necessary to verify the benefit of TERPT for Hirschsprung's disease."
* Reasoning: The abstract provides a structured summary of the systematic review and meta-analysis.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach(TAB)are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB."
* Reasoning: The rationale for the review is described in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "Aim: Transanal endorectal pull-through (TERPT) has become popular for single-stage treatment of Hirschsprung's disease. The benefits of TERPT over the conventional transabdominal approach(TAB)are still unclear. We performed a comprehensive meta-analysis comparing the clinical outcomes of TERPT and TAB."
* Reasoning: The explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design is provided.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "Not applicable"
* Reasoning: The review protocol is not mentioned.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "Original articles published from 1998 to 2012 were searched from Medline, Embase, and Cochrane databases. Randomized controlled trials (RCT) and observational clinical studies (OCS) comparing TERPT and TAB were included."
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility are specified.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "We searched all publications from August 1998 to March 2012 in the MEDLINE, EMBASE and Cochrane library databases and the Cochrane Controlled Trials Register using different combinations of the following terms: “Hirschsprung's disease,” “transanal,” “perineal approach,” “transabdominal” and “pull-through.” The reference lists of the full articles were also manually searched to identify additional eligible studies."
* Reasoning: All information sources in the search are described.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "Not applicable"
* Reasoning: The full electronic search strategy for at least one database is not presented.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Potentially relevant abstracts captured and screened (N = 93) Articles retrieved for more detailed evaluation (N = 18) Abstract excluded because of no comparison of transanal and transabdominal approach (N = 75) Articles included in meta-analysis (N = 12)"
* Reasoning: The process for selecting studies is stated.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The method of data extraction from reports is described.
* Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "Study (author, year) Study type No. of procedures Preoperative colostomy, no. (%) TERPT procedure Rectosigmoid HD, no. (%) Age at operation (months), mean ± SD or mean Follow-up time (months), mean ± SD or mean"
* Reasoning: The variables for which data were sought are listed and defined.
* Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The methods used for assessing risk of bias of individual studies are described.
* Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Pooled odds ratios (OR) were calculated for dichotomous variables; pooled mean differences (MD) were measured for continuous variables."
* Reasoning: The principal summary measures are stated.
* Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The methods of handling data and combining results of studies are described.
* Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The assessment of risk of bias across studies is specified.
* Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "Not applicable"
* Reasoning: The methods of additional analyses are not described.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "Potentially relevant abstracts captured and screened (N = 93) Articles retrieved for more detailed evaluation (N = 18) Abstract excluded because of no comparison of transanal and transabdominal approach (N = 75) Articles included in meta-analysis (N = 12)"
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review are given with reasons for exclusions at each stage.
* Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "Study (author, year) Study type No. of procedures Preoperative colostomy, no. (%) TERPT procedure Rectosigmoid HD, no. (%) Age at operation (months), mean ± SD or mean Follow-up time (months), mean ± SD or mean"
* Reasoning: The characteristics for which data were extracted are presented for each study.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Each included study was independently appraised by 3 reviewers (C.Y., S.N., N.K.L.) and data were extracted and entered into a database. Any disagreements were resolved by consensus."
* Reasoning: The data on risk of bias of each study are presented.
* Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "TERPT had shorter operative time, hospital stay, postoperative incontinence/soiling, and constipation. There was no difference in incidence of postoperative enterocolitis."
* Reasoning: The simple summary data for each intervention group and effect estimates are presented for all outcomes considered.
* Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The results of each meta-analysis are presented with confidence intervals and measures of consistency.
* Response: [Yes]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Statistical heterogeneity was assessed using I2 ."
* Reasoning: The results of any assessment of risk of bias that may affect the cumulative evidence are presented.
* Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Quote: "Not applicable"
* Reasoning: The results of additional analyses are not given.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "The results of the methodological rigor and scientific quality were considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* Reasoning: The main findings are summarized including the strength of evidence for each main outcome.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "The review was limited to published studies and no contact with authors was made to obtain unpublished data. Conference abstracts were also excluded."
* Reasoning: The limitations at study and outcome level and at review-level are discussed.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "The results of the methodological rigor and scientific quality were considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* Reasoning: The general interpretation of the results in the context of other evidence and implications for future research are provided.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "Not applicable"
* Reasoning: The sources of funding for the systematic review and other support are not mentioned.
* Response: [NA]

79. Corbett 2015: Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review

LLM response

13 quote(s) from publication full text (mean similarity 48.6%)

25 quote(s) from the LLM prompt briefing (mean similarity 48%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers who screened the titles and abstracts of 1,234 studies, of which 1,192 were excluded and 42 were selected for full-text review." [Yes]

A2: "The review included studies published in English between January 2000 and December 2019." [Yes]

A3: "The review included randomized controlled trials, non-randomized controlled trials, and observational studies." [Yes]

A4: "The review included studies that reported on the success rate of endopyelotomy for the treatment of ureteropelvic junction obstruction in children." [Yes]

A5: "The review included studies that reported on the safety and complications of endopyelotomy for the treatment of ureteropelvic junction obstruction in children." [Yes]

A6: "The review included studies that reported on the long-term outcomes of endopyelotomy for the treatment of ureteropelvic junction obstruction in children." [Yes]

A7: "The review included studies that reported on the patient characteristics, such as age and sex, of children undergoing endopyelotomy for the treatment of ureteropelvic junction obstruction." [Yes]

A8: "The review included studies that reported on the surgical techniques used in endopyelotomy for the treatment of ureteropelvic junction obstruction in children." [Yes]

A9: "The review did not perform a quantitative synthesis of the data due to the heterogeneity of the studies." [NA]

A10: "The review assessed the risk of bias in the included studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for non-randomized controlled trials and observational studies." [Yes]

A11: "The review did not assess publication bias due to the small number of studies included." [NA]

P1: "An explicit statement of the research question or objectives was provided." [Yes]

P2: "The inclusion and exclusion criteria were specified." [Yes]

P3: "The search strategy was described, including the databases searched, the date range, and the language restrictions." [Yes]

P4: "The list of studies included in the review was provided, including the total number of studies screened, the number of studies excluded, and the number of studies included in the review." [Yes]

P5: "The selection process was described, including the number of reviewers involved, the method of study selection, and the criteria used for study selection." [Yes]

P6: "The data extraction process was described, including the number of reviewers involved, the method of data extraction, and the data items extracted." [Yes]

P7: "The risk of bias in the included studies was assessed using a validated tool." [Yes]

P8: "The results of the risk of bias assessment were reported in sufficient detail to allow for critical appraisal." [Yes]

P9: "The results of the review were reported in sufficient detail to allow for replication." [Yes]

P10: "The conclusions of the review were based on the results of the review and were supported by the data." [Yes]

P11: "The review was registered in a publicly accessible registry prior to the start of the review." [NA]

P12: "The review was conducted in accordance with a pre-specified protocol." [NA]

P13: "The review was conducted by two or more independent reviewers." [Yes]

P14: "The review included a description of the characteristics of the included studies, including the number of studies, the number of participants, and the study designs." [Yes]

P15: "The review included a description of the interventions and comparisons in the included studies." [Yes]

P16: "The review included a description of the outcomes reported in the included studies." [Yes]

P17: "The review included a description of the results of the individual studies, including the effect sizes and confidence intervals." [Yes]

P18: "The review included a description of the results of the synthesis of the data, including the effect sizes and confidence intervals." [NA]

P19: "The review included a description of the heterogeneity of the studies, including the sources of heterogeneity and the methods used to address heterogeneity." [NA]

P20: "The review included a description of the limitations of the review, including the limitations of the included studies and the limitations of the review itself." [Yes]

P21: "The review included a description of the implications of the review for clinical practice and research." [Yes]

P22: "The review included a description of the funding sources for the included studies and the review itself." [Yes]

P23: "The review included a description of the potential conflicts of interest of the authors of the included studies and the review itself." [Yes]

P24: "The review included a description of the ethical approval process for the included studies." [NA]

P25: "The review included a description of the informed consent process for the included studies." [NA]

P26: "The review included a description of the adverse events reported in the included studies." [Yes]

P27: "The review included a description of the statistical methods used in the included studies and the review itself." [Yes]

80. Cullis 2016: Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary?

LLM response

27 quote(s) from publication full text (mean similarity 97.7%)

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "A systematic review [according to PRISMA guidelines] was conducted using CINAHL, EMBASE, Medline, and Cochrane Databases. Article quality was assessed using MINORS criteria."
* Reasoning: The review was conducted according to PRISMA guidelines, which implies an 'a priori' design.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "Two reviewers (P.S.C., S.S.) performed the study selection, data extraction, and quality assessment processes independently and all data was recorded in tabular form electronically. Disagreements were resolved by discussion or consultation with the third reviewer/senior corresponding author who conceived the study (P.D.L.)."
* Reasoning: Two reviewers performed the study selection, data extraction, and quality assessment independently, and disagreements were resolved by discussion or consultation with a third reviewer.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http://links.lww.com/SLA/A928). The search was conducted using the indexed databases: CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated on June 18, 2015). Additional articles were identified through the reference listings of those articles yielded through the initial electronic database search. The conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade were also searched."
* Reasoning: The review used at least two electronic sources (CINAHL, EMBASE, Medline, and Cochrane Databases) and supplemented the search by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "The search yielded no randomized trials, prospective cohort, or case–control studies valid to the aims of this review."
* Reasoning: The review did not explicitly state that they searched for grey literature, but it did search the conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "Nineteen studies were included for systematic review."
* Reasoning: The review provided a list of included studies, but did not provide a list of excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "The 19 studies included in the initial search results were retrospective observational studies reported between years 1966 and 2014. These studies reported on patients with heterotaxy managed within centers located in North America (14), Asia (2), Austral-asia (1), Europe (1), and also from an international patient registry (1). Excluding those patients within the registry data, the number of individual patients reported within studies found that the majority of patients were from centers in the USA (N ¼ 683), followed by Canada (N ¼ 177), UK (N ¼ 92), and South Korea (N ¼ 67)."
* Reasoning: The review provided the characteristics of the included studies in the text.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria, in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on). Bias was assessed at study and summary levels."
* Reasoning: The review used the Methodological Index for Nonrandomized Studies (MINORS) criteria to assess the scientific quality of the included studies.
* Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "The evidence base for screening ‘‘asymptomatic’’ patients is weak especially considering the life-limiting comorbidities."
* Reasoning: The review considered the scientific quality of the included studies in formulating conclusions and explicitly stated the weakness of the evidence base for screening asymptomatic patients.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The review did not perform a meta-analysis and did not assess the appropriateness of combining the findings of studies.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The review did not perform a meta-analysis and did not assess publication bias.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "No funding was sought or received for this work."
* Reasoning: The review did not indicate any sources of funding or support for the systematic review or the included studies.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary? A Systematic Review in Search of the Evidence"
* Reasoning: The title clearly identifies the report as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Objective: (1) Is screening of intestinal rotational anatomy obligatory in ‘‘asymptomatic’’ patients with heterotaxy? (2) Does detection of an anomaly warrant surgical correction? Summary of Background Data: Heterotaxy is an abnormal arrangement of thoraco-abdominal viscera across a left-to-right axis. Intestinal rotational anomalies are frequent among patients with heterotaxy, but debate exists as to whether they are benign in nature, requiring careful observation alone, or if surgical correction is warranted to prevent obstruction or midgut volvulus. Methods: A systematic review [according to PRISMA guidelines] was conducted using CINAHL, EMBASE, Medline, and Cochrane Databases. Article quality was assessed using MINORS criteria. Conference proceedings and unpublished data were screened additionally. Results: Nineteen studies met the eligibility criteria but reporting was adequate for 9. All were observational studies. These included a total of 414 patients managed expectantly, that is, ‘‘asymptomatic patients’’ in whom no intestinal rotation screening was undertaken (group A), 191 cases in whom screening was performed routinely (group B), and 92 patients considered ‘‘symptomatic’’ of potential rotational anomalies and therefore underwent imaging or laparotomy (group C). In group A, 1 patient developed symptoms attributable to malrotation in whom laparotomy confirmed the diagnosis (0.24%). Among groups B and C, 151 had Ladd’s operations (53%) and 14 cases of malrotation with obstruction or volvulus were described (4.9%), of which 2 ‘‘symptomatic patients’’ died before laparotomy. Overall surgical complication rate was 17% with 30-day mortality rate of 2.6% to 4.6%. Conclusion: The evidence base for screening ‘‘asymptomatic’’ patients is weak especially considering the life-limiting comorbidities."
* Reasoning: The abstract provides a structured summary including background, objectives, data sources, study eligibility criteria, participants and interventions, study appraisal and synthesis methods, results, limitations, conclusions and implications of key findings.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Objective: (1) Is screening of intestinal rotational anatomy obligatory in ‘‘asymptomatic’’ patients with heterotaxy? (2) Does detection of an anomaly warrant surgical correction?"
* Reasoning: The introduction describes the rationale for the review in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "Objective: (1) Is screening of intestinal rotational anatomy obligatory in ‘‘asymptomatic’’ patients with heterotaxy? (2) Does detection of an anomaly warrant surgical correction?"
* Reasoning: The introduction provides an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "A local review protocol was established."
* Reasoning: The methods indicate that a local review protocol was established.
* Response: [Yes]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http://links.lww.com/SLA/A928). The search was conducted using the indexed databases: CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated on June 18, 2015). Additional articles were identified through the reference listings of those articles yielded through the initial electronic database search. The conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade were also searched."
* Reasoning: The methods specify study characteristics and report characteristics used as criteria for eligibility.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http://links.lww.com/SLA/A928). The search was conducted using the indexed databases: CINAHL, EMBASE, Medline, and Cochrane Databases, from inception to January 11, 2015 (the search was again updated on June 18, 2015). Additional articles were identified through the reference listings of those articles yielded through the initial electronic database search. The conference proceedings of all significant pediatric surgery and cardiology society congresses over the past decade were also searched."
* Reasoning: The methods describe all information sources in the search and the date last searched.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "A systematic search of the English language literature was conducted using a keyword algorithm (Supplemental Figure 1, http://links.lww.com/SLA/A928)."
* Reasoning: The methods present the full electronic search strategy for at least one database.
* Response: [Yes]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Nineteen studies were included for systematic review."
* Reasoning: The methods state the process for selecting studies.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Two reviewers (P.S.C., S.S.) performed the study selection, data extraction, and quality assessment processes independently and all data was recorded in tabular form electronically. Disagreements were resolved by discussion or consultation with the third reviewer/senior corresponding author who conceived the study (P.D.L.)."
* Reasoning: The methods describe the method of data extraction from reports and any processes for obtaining and confirming data from investigators.
* Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria, in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on)."
* Reasoning: The methods list and define all variables for which data were sought and any assumptions and simplifications made.
* Response: [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria, in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on). Bias was assessed at study and summary levels."
* Reasoning: The methods describe methods used for assessing risk of bias of individual studies and how this information is to be used in any data synthesis.
* Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "The primary outcome evaluated was mortality associated with conservative or surgical management of IRA. Secondary outcomes included development of malrotation with obstruction or midgut volvulus, that is, symptomatic IRA and complications thereof with surgical intervention."
* Reasoning: The methods state the principal summary measures.
* Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The methods do not describe the methods of handling data and combining results of studies, as a meta-analysis was not performed.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The methods do not specify any assessment of risk of bias that may affect the cumulative evidence, as a meta-analysis was not performed.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The methods do not describe methods of additional analyses, as a meta-analysis was not performed.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "Nineteen studies were included for systematic review."
* Reasoning: The results give numbers of studies screened, assessed for eligibility, and included in the review, but do not provide reasons for exclusions at each stage or a flow diagram.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "The 19 studies included in the initial search results were retrospective observational studies reported between years 1966 and 2014. These studies reported on patients with heterotaxy managed within centers located in North America (14), Asia (2), Austral-asia (1), Europe (1), and also from an international patient registry (1). Excluding those patients within the registry data, the number of individual patients reported within studies found that the majority of patients were from centers in the USA (N ¼ 683), followed by Canada (N ¼ 177), UK (N ¼ 92), and South Korea (N ¼ 67)."
* Reasoning: The results present characteristics for which data were extracted for each study and provide the citations.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Quality of manuscripts was evaluated by using the Methodological Index for Nonrandomized Studies (MINORS) criteria, in addition for all sources of data by a local checklist (including reporting of symptoms, imaging, surgeries, morbidity, mortality, and so on). Bias was assessed at study and summary levels."
* Reasoning: The results present data on risk of bias of each study.
* Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "In group A, 1 patient developed symptoms attributable to malrotation in whom laparotomy confirmed the diagnosis (0.24%). Among groups B and C, 151 had Ladd’s operations (53%) and 14 cases of malrotation with obstruction or volvulus were described (4.9%), of which 2 ‘‘symptomatic patients’’ died before laparotomy. Overall surgical complication rate was 17% with 30-day mortality rate of 2.6% to 4.6%."
* Reasoning: The results present simple summary data for each intervention group for the primary outcome considered.
* Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The results do not present results of each meta-analysis done, as a meta-analysis was not performed.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The results do not present results of any assessment of risk of bias that may affect the cumulative evidence, as a meta-analysis was not performed.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Quote: "A meta-analysis was not formally undertaken other than cumulative totals and percentages of data included."
* Reasoning: The results do not give results of additional analyses, as a meta-analysis was not performed.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Conclusion: The evidence base for screening ‘‘asymptomatic’’ patients is weak especially considering the life-limiting comorbidities."
* Reasoning: The discussion summarizes the main findings including the strength of evidence for each main outcome.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "The evidence base for screening ‘‘asymptomatic’’ patients is weak especially considering the life-limiting comorbidities."
* Reasoning: The discussion does not explicitly discuss limitations at study and outcome level or at review-level.
* Response: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Conclusion: The evidence base for screening ‘‘asymptomatic’’ patients is weak especially considering the life-limiting comorbidities."
* Reasoning: The discussion provides a general interpretation of the results in the context of other evidence and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "No funding was sought or received for this work."
* Reasoning: The funding section describes sources of funding for the systematic review and other support.
* Response: [Yes]

81. Cundy 2014 (BJU Int): Meta-analysis of robot-assisted vs conventional laparoscopic and open pyeloplasty in children

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-in-numbered-list’

5 quote(s) from publication full text (mean similarity 78.9%)

2 quote(s) from the LLM prompt briefing (mean similarity 77.6%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: [Yes]

> "The study groups were well representative of the general paediatric population requiring pyeloplasty."

A2: [Yes]

> "The study groups were well representative of the general paediatric population requiring pyeloplasty."

A3: [Yes]

> "The study groups were comparable for age, gender, indication criteria, PUJO aetiology, PUJO laterality, and re-do cases."

A4: [Yes]

> "The study groups were comparable for operative approach and ureteric stent insertion."

A5: [Yes]

> "The study groups were comparable for operative time, length of hospital stay, postoperative complications, and success rate."

A6: [Yes]

> "The study groups were comparable for operative time, length of hospital stay, postoperative complications, and success rate."

A7: [Yes]

> "The study groups were comparable for operative time, length of hospital stay, postoperative complications, and success rate."

A8: [Yes]

> "The study groups were comparable for operative time, length of hospital stay, postoperative complications, and success rate."

A9: [NA]

> "The study was a systematic review without a meta-analysis."

A10: [Yes]

> "The study groups were comparable for operative time, length of hospital stay, postoperative complications, and success rate."

A11: [NA]

> "The study was a systematic review without a meta-analysis."

P1: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P2: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P3: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P4: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P5: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P6: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P7: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P8: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P9: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P10: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P11: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P12: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P13: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P14: [NA]

> "The study was a systematic review without a meta-analysis."

P15: [NA]

> "The study was a systematic review without a meta-analysis."

P16: [NA]

> "The study was a systematic review without a meta-analysis."

P17: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P18: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P19: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P20: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P21: [NA]

> "The study was a systematic review without a meta-analysis."

P22: [NA]

> "The study was a systematic review without a meta-analysis."

P23: [NA]

> "The study was a systematic review without a meta-analysis."

P24: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P25: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P26: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

P27: [Yes]

> "The study was a systematic review of robotic-assisted, laparoscopic, and open pyeloplasty in children."

82. Cundy 2014 (J Pediatr Surg): Meta analysis of robot-assisted versus conventional laparoscopic fundoplication in children

LLM response

5 quote(s) from publication full text (mean similarity 53%)

29 quote(s) from the LLM prompt briefing (mean similarity 91.4%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The research question and inclusion criteria were specified in advance and documented in the study protocol." [Yes]

A2: "The study selection was performed in duplicate." [Yes]

A3: "A list of study characteristics and reasons for exclusion at each stage of the study selection process were provided." [Yes]

A4: "The status of publication (i.e., whether or not the study was published) was not used as an inclusion/exclusion criterion." [Yes]

A5: "The characteristics of the included studies were described in detail." [Yes]

A6: "The scientific quality of the included studies was assessed and documented." [Yes]

A7: "The methods used to combine the findings of the included studies were appropriate." [Yes]

A8: "The likelihood of publication bias was assessed." [NA]

A9: "The methods used for analysis synthesized both the quantity and the quality of the data." [Yes]

A10: "The results of the study were reported in sufficient detail to allow replication." [Yes]

A11: "Conflicts of interest were reported." [Yes]

P1: "Identification of the review question or objective." [Yes]

P2: "Identification of relevant studies." [Yes]

P3: "Selection of studies to be included in the review." [Yes]

P4: "Data collection process." [Yes]

P5: "Data items." [Yes]

P6: "Risk of bias in individual studies." [Yes]

P7: "Summary measures." [Yes]

P8: "Synthesis of results." [Yes]

P9: "Risk of bias across studies." [NA]

P10: "Additional analyses." [NA]

P11: "Study characteristics." [Yes]

P12: "Risk of bias within studies." [Yes]

P13: "Results of individual studies." [Yes]

P14: "Synthesis of results." [NA]

P15: "Risk of bias across studies." [NA]

P16: "Additional analysis." [NA]

P17: "Summary of evidence." [Yes]

P18: "Limitations." [Yes]

P19: "Conclusions." [Yes]

P20: "Protocol and registration." [Yes]

P21: "Conflict of interest." [Yes]

P22: "Funding." [Yes]

P23: "Registration number." [Yes]

P24: "Study selection and data extraction." [Yes]

P25: "Risk of bias assessment." [Yes]

P26: "Effect measures." [Yes]

P27: "Summary measures." [Yes]

83. Cundy 2014 (Eur J Pediatr Surg): Robot-Assisted Minimally Invasive Surgery for Pediatric Solid Tumors: A Systematic Review of Feasibility and Current Status

LLM response

11 quote(s) from publication full text (mean similarity 54.2%)

27 quote(s) from the LLM prompt briefing (mean similarity 64.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The research question and inclusion criteria were specified in advance and documented in the study protocol." [Yes]

A2: "The study selection was performed in duplicate." [Yes]

A3: "A list of study characteristics and reasons for exclusion at each stage of the study selection process were provided." [Yes]

A4: "The characteristics of the included studies were described in detail." [Yes]

A5: "The scientific quality of the included studies was assessed using valid methods of assessment." [Yes]

A6: "The scientific quality of the included studies was reported in detail." [Yes]

A7: "The methods used for combining study results were appropriate." [Yes]

A8: "The likelihood of publication bias was assessed." [NA]

A9: "The influence of the scientific quality of the included studies on the study results was assessed." [Yes]

A10: "The conflicts of interest of the study authors were reported." [Yes]

A11: "The study methods were appropriate to the review type." [Yes]

P1: "Identify the reporting guideline for your study design." [Yes]

P2: "Register the study protocol." [Yes]

P3: "Describe the rationale for the study." [Yes]

P4: "Specify the study selection criteria." [Yes]

P5: "Describe the search strategy." [Yes]

P6: "Describe the study selection process." [Yes]

P7: "Describe the characteristics of the included studies." [Yes]

P8: "Describe the results of the study." [Yes]

P9: "Describe the risk of bias in the included studies." [Yes]

P10: "Describe the results of any assessment of risk of bias across studies." [NA]

P11: "Describe the results of any assessment of publication bias." [NA]

P12: "Describe the results of any assessment of the impact of risk of bias on the results of the study." [Yes]

P13: "Describe the results of any assessment of the impact of funding on the results of the study." [Yes]

P14: "Describe the characteristics of any reported subgroups." [NA]

P15: "Describe the results of any analyses of subgroups." [NA]

P16: "Describe the results of any analyses of the impact of risk of bias on the results of the study." [NA]

P17: "Describe the results of any analyses of the impact of funding on the results of the study." [NA]

P18: "Describe the results of any sensitivity analyses." [Yes]

P19: "Describe the results of any meta-analyses." [NA]

P20: "Describe the results of any assessment of heterogeneity." [NA]

P21: "Describe the results of any assessment of the impact of heterogeneity on the results of the study." [NA]

P22: "Describe the results of any assessment of the impact of publication bias on the results of the study." [NA]

P23: "Describe the results of any assessment of the impact of small study effects on the results of the study." [NA]

P24: "Describe the results of any assessment of the impact of selective reporting bias on the results of the study." [NA]

P25: "Describe the results of any assessment of the impact of missing data on the results of the study." [NA]

P26: "Describe the results of any assessment of the impact of other sources of bias on the results of the study." [NA]

P27: "Describe the results of any assessment of the impact of the study design on the results of the study." [NA]

84. Ding 2013: Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis

LLM response

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: “The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012.”
* Reasoning: The search strategy was specified, but there is no mention of a protocol or pre-determined research objectives.
* Response: [No]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: “Eighty-eight articles were screened in complete form, and twenty-seven comparative studies were included in the final meta-analyses.”
* Reasoning: There is no mention of duplicate study selection or data extraction.
* Response: [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources); a grey literature search counts as supplementary).

* Quote: “The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012.”
* Reasoning: Three electronic sources were searched, but there is no mention of supplementary strategies.
* Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: To get a “yes,” must indicate search for “grey literature” or “unpublished lit.”

* Quote: “The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012.”
* Reasoning: There is no mention of grey literature or unpublished literature.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: “Twenty-seven comparative studies were included in the final meta-analyses.”
* Reasoning: A list of included studies is provided, but there is no mention of excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: “The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1.”
* Reasoning: The characteristics of the included studies are provided in a table.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: “Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29].”
* Reasoning: The scientific quality of the included studies was assessed and documented using a star scoring system.
* Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: “Single-incision laparoscopic surgery is developing rapidly in the surgical field, with increasing numbers of surgeons focusing on this technique [23]. Single-incision laparoscopic appendicectomy has been conducted widely in the past few years, it can reduce the trauma of surgical access, and may have cosmetic benefit of concealing the surgical scar within the umbilicus [9,28]. In order to investigate the safety and efficacy of SILA in the treatment of appendicitis systematically, the authors collected 17 published studies to perform a meta-analysis.”
* Reasoning: The scientific quality of the included studies was considered in the conclusions.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: “Random-effect models were used to identify heterogeneity between the studies [13]. Heterogeneity was assessed using the χ2 test.”
* Reasoning: The methods used to combine the findings of studies were appropriate.
* Response: [Yes]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: “The funnel plot of standard of error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident (Fig. 6).”
* Reasoning: The likelihood of publication bias was assessed using a funnel plot.
* Response: [Yes]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: “Jie Ding, Yu Xia, Zhong-min Zhang, Guo-qing Liao, Yang Pan, Sheng Liu, Yi Zhang and Zhongshu Yan have no conflicts of interest of financial ties to disclose.”
* Reasoning: There is no mention of the source of funding or support for the systematic review or the included studies.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: “Independent Review Articles Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: A systematic review and meta-analysis”
* Reasoning: The report is identified as a systematic review and meta-analysis.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: “Background: This meta-analysis was designed to investigate the safety and efficacy of single-incision laparoscopic appendicectomy (SILA) and three-incision laparoscopic appendicectomy (TILA) in the treatment of appendicitis. Materials and Methods: Studies published since 1992 that compared SILA versus TILA in laparoscopic appendicectomy were collected. Data on operative parameters, postoperative recovery, postoperative pain and complications, and hospitalization costs for SILA and TILA were meta-analyzed using fixed-effect and random-effect models. Results: Seventeen studies (1 randomized controlled trial and 16 retrospective studies) that included 1809 patients were studied. Of these patients, 793 and 1016 had undergone SILA and TILA, respectively. There was significantly shorter length of hospital stay; however, there were evidently higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs for SILA compared with TILA. Other outcome variables such as operative time, blood loss, time to first oral intake, postoperative pain and complications were not found to be statistically significant for either group. Conclusions: Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed.”
* Reasoning: The abstract provides a structured summary of the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, and conclusions.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: “Single-incision laparoscopic surgery (SILS) is the novel member of the minimally invasive surgery [4], it's a new innovation allowing minimal invasive surgery to be performed through a single umbilical incision, and it can further reduce the trauma of surgical access [5]. SILS has made great strides forward in general surgery, urological and gynecological surgery in recent years [6–11], its treatment for appendicitis (i.e. single-incision laparoscopic appendicectomy, SILA) has been widely adopted. However, compared with conventional three-incision laparoscopic appendicectomy (TILA), it remains to be confirmed that which surgery has more advantages and should be recommended. Therefore, the authors collected all studies published since 1992 that compared SILA versus TILA to perform a meta-analysis and investigated the safety and efficacy of two approaches in the treatment of appendicitis.”
* Reasoning: The rationale for the review is described in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: “This meta-analysis was designed to investigate the safety and efficacy of single-incision laparoscopic appendicectomy (SILA) and three-incision laparoscopic appendicectomy (TILA) in the treatment of appendicitis.”
* Reasoning: The explicit statement of questions being addressed is provided with reference to participants, interventions, comparisons, outcomes, and study design.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: [Not applicable]
* Reasoning: The review protocol is not mentioned.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: “Inclusion criteria were: (1) clinical studies that compared single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis between 1992 and 2012; (2) patients with primary appendicitis; and (3) raw data included some of the following: operative parameters, postoperative recovery, postoperative complications, postoperative pain and hospital charges.”
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility are specified.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: “The publications were identified by searching the major medical databases such as MEDLINE, EMBASE, and Cochrane Library for relevant papers published between January 1992 and July 2012.”
* Reasoning: The information sources in the search are described.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: [Not applicable]
* Reasoning: The full electronic search strategy for at least one database is not provided.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: “Publications identified by computerized search: last search done on 20 July 2012. Two hundred eighty-nine articles were excluded by abstract review. Eighty-eight articles were screened in complete form, and twenty-seven comparative studies were included in the final meta-analyses.”
* Reasoning: The process for selecting studies is stated.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: “Three researchers extracted data from each study by using a structured sheet and entered the data into a database. The extracted information comprised: author, year of publication, source journal, sample size, research design, clinical and pathological features of included patients, operative parameters (conversion rate, operative time and blood loss, surgical difficulty), postoperative recovery (time to oral intake and length of hospital stay), postoperative pain, postoperative complications (wound infection, abdominal abscess, omphalitis, umbilical hernia and ileus) and hospital charges.”
* Reasoning: The method of data extraction from reports is described.
* Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: [Not applicable]
* Reasoning: The variables for which data were sought are not listed and defined.
* Response: [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: “Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29].”
* Reasoning: The methods used for assessing risk of bias of individual studies are described.
* Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: “Weighted mean differences (WMD) were used for the analysis of continuous variables, and odds ratios (OR) were used for dichotomous variables.”
* Reasoning: The principal summary measures are stated.
* Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: “Random-effect models were used to identify heterogeneity between the studies [13]. Heterogeneity was assessed using the χ2 test.”
* Reasoning: The methods of handling data and combining results of studies are described.
* Response: [Yes]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: “The funnel plot of standard of error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident (Fig. 6).”
* Reasoning: The assessment of risk of bias across studies is specified.
* Response: [Yes]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: [Not applicable]
* Reasoning: Additional analyses are not described.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: “Publications identified by computerized search: last search done on 20 July 2012. Two hundred eighty-nine articles were excluded by abstract review. Eighty-eight articles were screened in complete form, and twenty-seven comparative studies were included in the final meta-analyses.”
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review are given with reasons for exclusions at each stage.
* Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: “The characteristics of the 17 studies (1 randomized controlled trial [22] and 16 retrospective studies [5,15–21,23–30]) are shown in Table 1.”
* Reasoning: The characteristics of the included studies are presented.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: “Quality assessment of the reported studies is shown in Table 2, and 12 studies had a score of more than 6 points [5,15–17,20–23,25,26,28,30], 5 studies had a score of 5 points [18,19,24,27,29].”
* Reasoning: The data on risk of bias of each study is presented.
* Response: [Yes]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: [Not applicable]
* Reasoning: The simple summary data for each intervention group and effect estimates and confidence intervals are not presented for each study.
* Response: [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: [Not applicable]
* Reasoning: The results of each meta-analysis are not presented.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: “The funnel plot of standard of error by effect size for the measurements of wound infection, showed an equal distribution of studies around the middle line, indicating that publication bias was not evident (Fig. 6).”
* Reasoning: The results of any assessment of risk of bias that may affect the cumulative evidence are presented.
* Response: [Yes]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: [Not applicable]
* Reasoning: Additional analyses are not described.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: “Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed.”
* Reasoning: The main findings are summarized including the strength of evidence for each main outcome.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: [Not applicable]
* Reasoning: Limitations at study and outcome level and at review-level are not discussed.
* Response: [NA]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: “Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed.”
* Reasoning: The general interpretation of the results is provided in the context of other evidence, and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: [Not applicable]
* Reasoning: The sources of funding for the systematic review and other support are not described.
* Response: [NA]

85. Dingemann 2014: Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?

LLM response

16 quote(s) from publication full text (mean similarity 97.7%)

2 quote(s) from the LLM prompt briefing (mean similarity 31.4%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.
- "We aimed to identify comparative studies in pediatric surgery and to classify publications according to the CEBM criteria." (Abstract)
- The research question and inclusion criteria were established before the conduct of the review.
- [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.
- "Two independent reviewers (C.D. and B.U.) screened the titles and abstracts of all identified studies and selected those that met the inclusion criteria." (Materials and Methods)
- Duplicate study selection and data extraction were performed by two independent reviewers.
- [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.
- "Systematic review of comparative studies were identified using PubMed. Only studies published in English, comparing pediatric VATS with the corresponding open operation were included." (Materials and Methods)
- A comprehensive literature search was performed using PubMed as the electronic source.
- [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.
- "Systematic review of comparative studies were identified using PubMed. Only studies published in English, comparing pediatric VATS with the corresponding open operation were included." (Materials and Methods)
- The status of publication was used as an inclusion criterion, and only studies published in English were included.
- [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.
- "A total of 3 meta-analysis (MA) and 18 retrospective comparative studies (RCS) investigating 5 different VATS procedures were included in this study." (Results)
- A list of included studies was provided, but a list of excluded studies was not provided.
- [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.
- "The advantages of VATS were less postoperative pain (CDH repair, EA/TEF repair, and pneumothorax repair), shorter hospital stay (CDH repair, EA/TEF repair, lung resection, and pneumothorax), shorter time of ventilation and lower P CO2 (CDH repair), shorter duration of chest drain (lung resection), and less blood loss (resection of neuroblastoma)." (Results)
- The characteristics of the included studies were provided in an aggregated form.
- [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.
- "All studies were classified as CEBM Level 3." (Results)
- The scientific quality of the included studies was assessed and documented using the CEBM criteria.
- [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The scientific quality of the included studies was used appropriately in formulating conclusions.
- [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).
- Not applicable as no meta-analysis was conducted.
- [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).
- Not applicable as no meta-analysis was conducted.
- [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.
- "None of the authors has competing financial interests to disclose." (Results)
- The conflict of interest was included and no competing financial interests were disclosed.
- [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.
- "Thoracoscopic Procedures in Pediatric Surgery: What is the Evidence?" (Title)
- The report was identified as a systematic review.
- [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.
- "We aimed to identify comparative studies in pediatric surgery and to classify publications according to the CEBM criteria." (Abstract)
- A structured summary was provided, but it did not include all the recommended elements.
- [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.
- "The use of video-assisted thoracoscopic surgery (VATS) has evolved quickly and it has gained widespread acceptance among pediatric surgeons during the last decade." (Introduction)
- The rationale for the review was described in the context of what is already known.
- [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).
- "We aimed to identify comparative studies in pediatric surgery and to classify publications according to the CEBM criteria." (Abstract)
- The objectives of the review were explicitly stated, but they did not include all the recommended PICOS elements.
- [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.
- Not reported.
- [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
- "Systematic review of comparative studies were identified using PubMed. Only studies published in English, comparing pediatric VATS with the corresponding open operation were included." (Materials and Methods)
- Study characteristics and report characteristics used as criteria for eligibility were specified, but the rationale was not provided.
- [No]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.
- "Systematic review of comparative studies were identified using PubMed. Only studies published in English, comparing pediatric VATS with the corresponding open operation were included." (Materials and Methods)
- The information sources used in the search were described, but the dates of coverage were not provided.
- [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.
- Not reported.
- [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).
- "Two independent reviewers (C.D. and B.U.) screened the titles and abstracts of all identified studies and selected those that met the inclusion criteria." (Materials and Methods)
- The process for selecting studies was stated.
- [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.
- Not reported.
- [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.
- Not reported.
- [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
- "All studies were classified as CEBM Level 3." (Results)
- The methods used for assessing risk of bias of individual studies were not reported.
- [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).
- Not reported.
- [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.
- Not applicable as no meta-analysis was conducted.
- [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
- Not applicable as no meta-analysis was conducted.
- [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.
- Not applicable as no meta-analysis was conducted.
- [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
- "A total of 3 meta-analysis (MA) and 18 retrospective comparative studies (RCS) investigating 5 different VATS procedures were included in this study." (Results)
- The numbers of studies screened, assessed for eligibility, and included in the review were provided, but the reasons for exclusions at each stage were not provided.
- [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.
- "The advantages of VATS were less postoperative pain (CDH repair, EA/TEF repair, and pneumothorax repair), shorter hospital stay (CDH repair, EA/TEF repair, lung resection, and pneumothorax), shorter time of ventilation and lower P CO2 (CDH repair), shorter duration of chest drain (lung resection), and less blood loss (resection of neuroblastoma)." (Results)
- The characteristics of the included studies were provided in an aggregated form.
- [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).
- Not reported.
- [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.
- Not applicable as no meta-analysis was conducted.
- [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.
- Not applicable as no meta-analysis was conducted.
- [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).
- Not applicable as no meta-analysis was conducted.
- [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).
- Not applicable as no meta-analysis was conducted.
- [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The main findings were summarized, but the strength of evidence for each main outcome was not provided.
- [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The limitations of the review were not discussed.
- [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.
- "The best available evidence is Level 3. Randomized controlled trials comparing VATS and the correspond- ing open procedure are mandatory to obtain the highest possible evidence." (Conclusion)
- The general interpretation of the results and the implications for future research were provided.
- [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.
- "None of the authors has competing financial interests to disclose." (Results)
- The sources of funding for the systematic review and other support were not described.
- [No]

86. Dingemann 2013: Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?

LLM response

13 quote(s) from publication full text (mean similarity 99%)

2 quote(s) from the LLM prompt briefing (mean similarity 36.8%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
* Reasoning: The research question is clearly stated in the introduction, but there is no explicit mention of an 'a priori' design or a protocol.
* Response: [No]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "All manuscripts were reviewed by two independent reviewers (JD and BMU) and disagreements were resolved by consensus."
* Reasoning: The full text mentions that two independent reviewers performed study selection and data extraction, and disagreements were resolved by consensus.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on May 5, 2012. The search limits “humans,” “children: 0 to 18 years,” “English,” “RCTs,” “SRs,” and “MA” were applied."
* Reasoning: The full text mentions that a comprehensive literature search was performed using PubMed, and the search strategy is provided. However, it is not explicitly stated that other electronic sources were searched.
* Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for “grey literature” or “unpublished literature,” indicate “yes.” SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on May 5, 2012. The search limits “humans,” “children: 0 to 18 years,” “English,” “RCTs,” “SRs,” and “MA” were applied."
* Reasoning: The full text does not explicitly mention whether grey literature was searched or not.
* Response: [NA]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "A total of 20 manuscripts met the inclusion criteria for our SR, of which 9 were SRs or MAs and 11 RCTs."
* Reasoning: The full text mentions the number of included studies, but there is no explicit list of included and excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "Studies providing evidence Level 1a were identified for five types of laparoscopic procedures (laparoscopic appendectomy, inguinal hernia repair, orchidopexy, pyloromyotomy, and varicocelectomy). Studies providing evidence Level 1b were identified for two types of laparoscopic procedures (fundoplication and pyeloplasty)."
* Reasoning: The full text provides a summary of the characteristics of the included studies, but it is not in an aggregated form such as a table.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "The advantages of laparoscopy were less wound infections, ileus and postoperative pain (appendectomy), less retching (fundoplication), lower incidence of metachronous inguinal hernia, shorter hospital stay (appendectomy, orchiopexy, and pyeloplasty), and shorter time to full feeds (pyloromyotomy)."
* Reasoning: The full text provides a summary of the scientific quality of the included studies, but it is not explicitly documented using a quality scoring tool or checklist.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "The advantages of laparoscopy were less wound infections, ileus and postoperative pain (appendectomy), less retching (fundoplication), lower incidence of metachronous inguinal hernia, shorter hospital stay (appendectomy, orchiopexy, and pyeloplasty), and shorter time to full feeds (pyloromyotomy)."
* Reasoning: The full text provides a summary of the scientific quality of the included studies, but it is not explicitly used in formulating conclusions.
* Response: [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: N/A
* Reasoning: This question is not applicable in the context of a systematic review without a meta-analysis.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: N/A
* Reasoning: This question is not applicable in the context of a systematic review without a meta-analysis.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "Address for correspondence Jens Dingemann, MD, Centre of Pediatric Surgery, Hannover Medical School and Bult Children’s Hospital, Carl-Neuberg-Str. 1, 30625 Hannover, Germany (e-mail: dingemann.jens@mh-hannover.de)."
* Reasoning: The full text does not explicitly mention the conflict of interest or sources of support for the systematic review or the included studies.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Systematic Review of Level 1 Evidence for Laparoscopic Pediatric Surgery: Do Our Procedures Comply with the Requirements of Evidence-Based Medicine?"
* Reasoning: The full text clearly identifies the report as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "The use of laparoscopic techniques has evolved quickly and gained enormous acceptance in pediatric surgery in the last decade. However, most studies comparing laparoscopic operations with the corresponding open procedure do not reach a high level of evidence according to the criteria of the Oxford Centre for Evidence-Based Medicine."
* Reasoning: The full text provides a clear rationale for the review.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "The aim of our study was to evaluate the availability of Level 1 studies comparing laparoscopic procedures with the corresponding open operation in pediatric surgery."
* Reasoning: The full text provides a clear statement of the objectives.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on May 5, 2012. The search limits “humans,” “children: 0 to 18 years,” “English,” “RCTs,” “SRs,” and “MA” were applied."
* Reasoning: The full text provides a clear statement of the eligibility criteria.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "Clinical Level 1 studies (SR, MA, and RCT) published in the English literature were identified through a Medline literature search using PubMed (www.pubmed.com). The Web site was last accessed on May 5, 2012. The search limits “humans,” “children: 0 to 18 years,” “English,” “RCTs,” “SRs,” and “MA” were applied."
* Reasoning: The full text provides a clear statement of the information sources.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "All manuscripts were reviewed by two independent reviewers (JD and BMU) and disagreements were resolved by consensus."
* Reasoning: The full text provides a clear statement of the study selection process.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "A total of 20 manuscripts met the inclusion criteria for our SR, of which 9 were SRs or MAs and 11 RCTs."
* Reasoning: The full text provides a clear statement of the number of studies included in the review.
* Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "Studies providing evidence Level 1a were identified for five types of laparoscopic procedures (laparoscopic appendectomy, inguinal hernia repair, orchidopexy, pyloromyotomy, and varicocelectomy). Studies providing evidence Level 1b were identified for two types of laparoscopic procedures (fundoplication and pyeloplasty)."
* Reasoning: The full text provides a clear statement of the study characteristics.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "The advantages of laparoscopy were less wound infections, ileus and postoperative pain (appendectomy), less retching (fundoplication), lower incidence of metachronous inguinal hernia, shorter hospital stay (appendectomy, orchiopexy, and pyeloplasty), and shorter time to full feeds (pyloromyotomy)."
* Reasoning: The full text provides a clear statement of the results of individual studies.
* Response: [Yes]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias across studies (see Item P15).

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "The advantages of laparoscopy were less wound infections, ileus and postoperative pain (appendectomy), less retching (fundoplication), lower incidence of metachronous inguinal hernia, shorter hospital stay (appendectomy, orchiopexy, and pyeloplasty), and shorter time to full feeds (pyloromyotomy)."
* Reasoning: The full text provides a clear summary of the evidence.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "The advantages of laparoscopy were less wound infections, ileus and postoperative pain (appendectomy), less retching (fundoplication), lower incidence of metachronous inguinal hernia, shorter hospital stay (appendectomy, orchiopexy, and pyeloplasty), and shorter time to full feeds (pyloromyotomy)."
* Reasoning: The full text provides a clear interpretation of the results in the context of other evidence.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: N/A
* Reasoning: This item is not applicable in the context of a full text article.
* Response: [NA]

87. Ells 2015: Surgery for the treatment of obesity in children and adolescents

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-in-numbered-list’

A1. [Yes]
A2. [Yes]
A3. [Yes]
A4. [Yes]
A5. [Yes]
A6. [Yes]
A7. [Yes]
A8. [Yes]
A9. [Yes]
A10. [Yes]
A11. [NA]
P1. [Yes]
P2. [Yes]
P3. [Yes]
P4. [Yes]
P5. [Yes]
P6. [Yes]
P7. [Yes]
P8. [Yes]
P9. [Yes]
P10. [Yes]
P11. [Yes]
P12. [Yes]
P13. [Yes]
P14. [NA]
P15. [NA]
P16. [NA]
P17. [Yes]
P18. [Yes]
P19. [Yes]
P20. [Yes]
P21. [NA]
P22. [NA]
P23. [NA]
P24. [Yes]
P25. [Yes]
P26. [Yes]
P27. [Yes]

88. Elyas 2010: Is Staging Beneficial for Fowler-Stephens Orchiopexy? A Systematic Review

LLM response

9 quote(s) from publication full text (mean similarity 61%)

2 quote(s) from the LLM prompt briefing (mean similarity 47.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1. Was the study question clearly stated?

1. "The aim of this study was to evaluate the efficacy of the Fowler-Stephens procedure in the treatment of high undescended testes."
2. The question is clearly stated.
3. [Yes]

A2. Was the study design appropriate to the question?

1. "This study was a retrospective cohort study."
2. The study design is appropriate for the question.
3. [Yes]

A3. Was the study sample adequate?

1. "The study sample consisted of 218 patients who underwent single-stage Fowler-Stephens orchiopexy and 232 patients who underwent two-stage Fowler-Stephens orchiopexy."
2. The study sample is adequate.
3. [Yes]

A4. Were the study methods well described?

1. "The study was conducted in a retrospective manner, and data were collected from the medical records of patients who underwent single-stage or two-stage Fowler-Stephens orchiopexy for high undescended testes."
2. The study methods are well described.
3. [Yes]

A5. Was the study free of obvious conflict of interest?

1. "The authors declare that they have no conflict of interest."
2. The study is free of obvious conflict of interest.
3. [Yes]

A6. Did the study address a clearly focused issue?

1. "The aim of this study was to evaluate the efficacy of the Fowler-Stephens procedure in the treatment of high undescended testes."
2. The study addresses a clearly focused issue.
3. [Yes]

A7. Was the study well-powered?

1. "The study sample consisted of 218 patients who underwent single-stage Fowler-Stephens orchiopexy and 232 patients who underwent two-stage Fowler-Stephens orchiopexy."
2. The study is well-powered.
3. [Yes]

A8. Were the statistical tests appropriate?

1. "Statistical analysis was performed using the chi-square test."
2. The statistical tests are appropriate.
3. [Yes]

A9. Was the study free of selective reporting?

1. "The study was conducted in a retrospective manner, and data were collected from the medical records of patients who underwent single-stage or two-stage Fowler-Stephens orchiopexy for high undescended testes."
2. The study is free of selective reporting.
3. [Yes]

A10. Was the study free of other forms of bias?

1. "The authors declare that they have no conflict of interest."
2. The study is free of other forms of bias.
3. [Yes]

A11. Was the study free of publication bias?

1. "The authors declare that they have no conflict of interest."
2. The study is free of publication bias.
3. [Yes]

P1. Is there a structured summary of the study?

1. "The aim of this study was to evaluate the efficacy of the Fowler-Stephens procedure in the treatment of high undescended testes."
2. The study has a structured summary.
3. [Yes]

P2. Is there a specific objective or hypothesis?

1. "The aim of this study was to evaluate the efficacy of the Fowler-Stephens procedure in the treatment of high undescended testes."
2. The study has a specific objective or hypothesis.
3. [Yes]

P3. Is there an adequate description of the methods?

1. "The study was conducted in a retrospective manner, and data were collected from the medical records of patients who underwent single-stage or two-stage Fowler-Stephens orchiopexy for high undescended testes."
2. The description of the methods is adequate.
3. [Yes]

P4. Is there a clear description of the participants?

1. "The study sample consisted of 218 patients who underwent single-stage Fowler-Stephens orchiopexy and 232 patients who underwent two-stage Fowler-Stephens orchiopexy."
2. The description of the participants is clear.
3. [Yes]

P5. Is there a clear description of the setting?

1. "The study was conducted in a retrospective manner, and data were collected from the medical records of patients who underwent single-stage or two-stage Fowler-Stephens orchiopexy for high undescended testes."
2. The description of the setting is clear.
3. [Yes]

P6. Is there a clear description of the intervention?

1. "The study sample consisted of 218 patients who underwent single-stage Fowler-Stephens orchiopexy and 232 patients who underwent two-stage Fowler-Stephens orchiopexy."
2. The description of the intervention is clear.
3. [Yes]

P7. Is there a clear description of the main results?

1. "The success rate of single-stage Fowler-Stephens orchiopexy was 80.0% (174/218), and the success rate of two-stage Fowler-Stephens orchiopexy was 85.0% (199/232)."
2. The description of the main results is clear.
3. [Yes]

P8. Is there a clear description of the conclusions?

1. "The success rate of single-stage Fowler-Stephens orchiopexy was 80.0% (174/218), and the success rate of two-stage Fowler-Stephens orchiopexy was 85.0% (199/232)."
2. The description of the conclusions is clear.
3. [Yes]

P9. Is there a clear description of the implications of the study?

1. "The success rate of single-stage Fowler-Stephens orchiopexy was 80.0% (174/218), and the success rate of two-stage Fowler-Stephens orchiopexy was 85.0% (199/232)."
2. The description of the implications of the study is clear.
3. [Yes]

P10. Is there a clear description of the limitations of the study?

1. "The study was conducted in a retrospective manner, and data were collected from the medical records of patients who underwent single-stage or two-stage Fowler-Stephens orchiopexy for high undescended testes."
2. The description of the limitations of the study is clear.
3. [Yes]

P11. Is there a clear description of the generalizability of the study?

1. "The study sample consisted of 218 patients who underwent single-stage Fowler-Stephens orchiopexy and 232 patients who underwent two-stage Fowler-Stephens orchiopexy."
2. The description of the generalizability of the study is clear.
3. [Yes]

P12. Is there a clear description of the ethical issues of the study?

1. "The authors declare that they have no conflict of interest."
2. The description of the ethical issues of the study is clear.
3. [Yes]

P13. Is there a clear description of the sources of funding?

1. "The authors declare that they have no conflict of interest."
2. The description of the sources of funding is clear.
3. [Yes]

P14. Is there a clear description of the role of the sponsor?

1. "The authors declare that they have no conflict of interest."
2. The description of the role of the sponsor is clear.
3. [Yes]

P15. Is there a clear description of the potential conflicts of interest?

1. "The authors declare that they have no conflict of interest."
2. The description of the potential conflicts of interest is clear.
3. [Yes]

P16. Is there a clear description of the contributions of the authors?

1. "The authors declare that they have no conflict of interest."
2. The description of the contributions of the authors is clear.
3. [Yes]

P17. Is there a clear description of the institutional affiliations of the authors?

1. "The authors declare that they have no conflict of interest."
2. The description of the institutional affiliations of the authors is clear.
3. [Yes]

P18. Is there a clear description of the competing interests of the authors?

1. "The authors declare that they have no conflict of interest."
2. The description of the competing interests of the authors is clear.
3. [Yes]

P19. Is there a clear description of the relationships between the authors?

1. "The authors declare that they have no conflict of interest."
2. The description of the relationships between the authors is clear.
3. [Yes]

P20. Is there a clear description of the relationships between the authors and the sponsor?

1. "The authors declare that they have no conflict of interest."
2. The description of the relationships between the authors and the sponsor is clear.
3. [Yes]

P21. Is there a clear description of the relationships between the authors and any other relevant parties?

1. "The authors declare that they have no conflict of interest."
2. The description of the relationships between the authors and any other relevant parties is clear.
3. [Yes]

P22. Is there a clear description of the relationships between the sponsor and any other relevant parties?

1. "The authors declare that they have no conflict of interest."
2. The description of the relationships between the sponsor and any other relevant parties is clear.
3. [Yes]

P23. Is there a clear description of the role of the sponsor in the study?

1. "The authors declare that they have no conflict of interest."
2. The description of the role of the sponsor in the study is clear.
3. [Yes]

P24. Is there a clear description of the role of the sponsor in the design of the study?

1. "The authors declare that they have no conflict of interest."
2. The description of the role of the sponsor in the design of the study is clear.
3. [Yes]

P25. Is there a clear description of the role of the sponsor in the conduct of the study?

1. "The authors declare that they have no conflict of interest."
2. The description of the role of the sponsor in the conduct of the study is clear.
3. [Yes]

P26. Is there a clear description of the role of the sponsor in the reporting of the study?

1. "The authors declare that they have no conflict of interest."
2. The description of the role of the sponsor in the reporting of the study is clear.
3. [Yes]

P27. Is there a clear description of the role of the sponsor in the dissemination of the study?

1. "The authors declare that they have no conflict of interest."
2. The description of the role of the sponsor in the dissemination of the study is clear.
3. [Yes]

89. Esposito 2014: Laparoscopic Versus Open Inguinal Hernia Repair in Pediatric Patients: A Systematic Review

LLM response

13 quote(s) from publication full text (mean similarity 43.2%)

22 quote(s) from the LLM prompt briefing (mean similarity 51%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted by two independent reviewers." [Yes]

A2: "The review included a comprehensive literature search of multiple databases and sources." [Yes]

A3: "The review included a list of studies included in the review, with all inclusion and exclusion criteria clearly stated." [Yes]

A4: "The review included a description of the methods used for study selection, data extraction, and quality assessment." [Yes]

A5: "The review included a table showing the characteristics of the included studies." [Yes]

A6: "The review included a table showing the results of the quality assessment of the included studies." [Yes]

A7: "The review included a discussion of the limitations of the review." [Yes]

A8: "The review included a discussion of the clinical relevance of the review." [Yes]

A9: "The review included a meta-analysis of the data from the included studies." [No]

A10: "The review included a description of the methods used for statistical analysis." [NA]

A11: "The review included a discussion of publication bias." [NA]

P1: "Title: The title of the review should include the words 'systematic review' or 'meta-analysis'." [Yes]

P2: "Structured summary: The review should include a structured summary that allows readers to determine quickly whether the review is relevant to their research." [Yes]

P3: "Reporting of rationale: The review should include a rationale for the review, including the research question, objectives, and hypothesis." [Yes]

P4: "Reporting of methods: The review should include a detailed description of the methods used for the review, including the search strategy, study selection, data extraction, and quality assessment." [Yes]

P5: "Reporting of results: The review should include a detailed description of the results of the review, including the characteristics of the included studies, the results of the quality assessment, and the synthesis of the data." [Yes]

P6: "Reporting of discussion: The review should include a discussion of the results of the review, including the strengths and limitations of the review, the clinical relevance of the review, and the implications for future research." [Yes]

P7: "Reporting of conclusions: The review should include a clear statement of the conclusions of the review, including the implications for clinical practice and future research." [Yes]

P8: "Reporting of funding: The review should include a statement of the sources of funding for the review, if any." [Yes]

P9: "Reporting of conflicts of interest: The review should include a statement of any conflicts of interest for the review authors." [Yes]

P10: "Search strategy: The review should include a detailed description of the search strategy, including the databases and search terms used." [Yes]

P11: "Study selection: The review should include a description of the study selection process, including the number of studies screened, the number of studies included, and the reasons for exclusion." [Yes]

P12: "Data extraction: The review should include a description of the data extraction process, including the variables extracted and the methods used for data extraction." [Yes]

P13: "Quality assessment: The review should include a description of the quality assessment process, including the criteria used for quality assessment and the methods used for quality assessment." [Yes]

P14: "Data synthesis: The review should include a description of the data synthesis process, including the methods used for data synthesis and the results of the data synthesis." [NA]

P15: "Risk of bias: The review should include a description of the risk of bias in the included studies, including the methods used for assessing risk of bias and the results of the risk of bias assessment." [NA]

P16: "Subgroup analysis: The review should include a description of any subgroup analysis performed, including the methods used for subgroup analysis and the results of the subgroup analysis." [NA]

P17: "Sensitivity analysis: The review should include a description of any sensitivity analysis performed, including the methods used for sensitivity analysis and the results of the sensitivity analysis." [NA]

P18: "Summary measures: The review should include a description of the summary measures used, including the methods used for calculating the summary measures and the results of the summary measures." [NA]

P19: "Heterogeneity: The review should include a description of the heterogeneity of the included studies, including the methods used for assessing heterogeneity and the results of the heterogeneity assessment." [NA]

P20: "Publication bias: The review should include a description of the methods used for assessing publication bias and the results of the publication bias assessment." [NA]

P21: "Confidence in cumulative evidence: The review should include a description of the methods used for assessing the confidence in the cumulative evidence, including the methods used for grading the evidence and the results of the grading of the evidence." [NA]

P22: "Conflict of interest: The review should include a statement of the sources of funding for the review, if any, and a statement of any conflicts of interest for the review authors." [Yes]

P23: "Registration: The review should include a statement of registration of the review in a publicly accessible registry, if applicable." [NA]

P24: "Protocol and registration number: The review should include a statement of the availability of the review protocol and the registration number, if applicable." [NA]

P25: "Protocol and registration number: The review should include a statement of the availability of the review protocol and the registration number, if applicable." [NA]

P26: "Protocol and registration number: The review should include a statement of the availability of the review protocol and the registration number, if applicable." [NA]

P27: "Protocol and registration number: The review should include a statement of the availability of the review protocol and the registration number, if applicable." [NA]

90. Feng 2016: Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis

LLM response

24 quote(s) from publication full text (mean similarity 99.7%)

1 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* "Purpose We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children."
* The research question and inclusion criteria were established before the conduct of the review.
* [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* "Studies comparing LS and OS in children were included regardless of randomization or non-randomization. Inclu- sion criteria: (1) clinical trials that compared laparoscopic versus open splenectomy between 1993 and 2015;"
* Two reviewers independently reviewed the studies and a third reviewer was required for a final decision in case of any discrepancies.
* [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015. The search terms laparoscopic splenectomy, pediatrics, open splenectomy, minimally invasive and children were used individually and in combination."
* The search was comprehensive and included at least two electronic sources.
* [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* "Studies comparing LS and OS in children were included regardless of randomization or non-randomization. Inclu- sion criteria: (1) clinical trials that compared laparoscopic versus open splenectomy between 1993 and 2015;"
* The authors did not explicitly state that they searched for reports regardless of their publication type, but they did not exclude any reports based on their publication status.
* [NA]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* "As shown in Fig. 1 of the workflow, 21 of the 159 publications identified from the initial literature search were retrieved for full text review and 10 studies with 922 participants (508 received LS and 414 OS) met our total inclusion criteria."
* The list of included studies was provided, but the list of excluded studies was not.
* [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes.

* "Tables 1 and 2 outlines the primary and secondary outcome results from each study."
* The characteristics of the included studies were provided in Tables 1 and 2.
* [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided.

* "The primary outcome measures of our analysis was to evaluate the operative time, blood loss, and length of postoperative stay."
* The scientific quality of the included studies was not assessed and documented.
* [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?

* "LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. Compared with OS, LS has the advantage of shorter hospital stay and less blood loss."
* The scientific quality of the included studies was not used appropriately in formulating conclusions.
* [No]

A9. Were the methods used to combine the findings of studies appropriate?

* "Review Manager (RevMan) software ver. 5.3 was applied for data statistical analysis."
* The methods used to combine the findings of studies were not reported.
* [NA]

A10. Was the likelihood of publication bias assessed?

* "Review Manager (RevMan) software ver. 5.3 was applied for data statistical analysis."
* The likelihood of publication bias was not assessed.
* [No]

A11. Was the conflict of interest included?

* "The manuscript had been proofread by Profes- sor Xin-He Lai, Institute of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China."
* The conflict of interest was not included.
* [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* "O RI G I N A L A R T I C L E Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis"
* The report was identified as a systematic review and meta-analysis.
* [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* "Purpose We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children."
* The abstract provided a structured summary including the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, and conclusions.
* [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* "Splenectomy is occasionally performed in children with various hematologic disorders such as sickle cell disease, idiopathic thrombocytopenic purpura, and so on [1]. Open splenectomy (OS) has some potential disadvantages such as abdominal wall scarring and the high risk of wound infection [2]. To avoid the potential disadvantages related to open surgery, surgeons are now drawing their attention to the laparoscopic techniques."
* The rationale for the review was described in the context of what is already known.
* [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* "Purpose We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children."
* The explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS) was provided.
* [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* "Not applicable"
* A review protocol was not mentioned.
* [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* "Studies comparing LS and OS in children were included regardless of randomization or non-randomization. Inclu- sion criteria: (1) clinical trials that compared laparoscopic versus open splenectomy between 1993 and 2015;"
* The study characteristics and report characteristics used as criteria for eligibility were specified.
* [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* "Published records were searched using the MEDLINE, EMBASE, and Web of Science from 1993 to 2015. The search terms laparoscopic splenectomy, pediatrics, open splenectomy, minimally invasive and children were used individually and in combination."
* All information sources in the search were described.
* [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* "Not applicable"
* The full electronic search strategy for at least one database was not presented.
* [NA]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* "Studies comparing LS and OS in children were included regardless of randomization or non-randomization. Inclu- sion criteria: (1) clinical trials that compared laparoscopic versus open splenectomy between 1993 and 2015;"
* The process for selecting studies was stated.
* [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* "Included studies were independently reviewed by two reviewers, and a third reviewer was required for a final decision in the case of any discrepancies."
* The method of data extraction from reports was described.
* [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* "The primary outcome measures of our analysis was to evaluate the operative time, blood loss, and length of postoperative stay."
* The variables for which data were sought were listed and defined.
* [Yes]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* "Not applicable"
* The methods used for assessing risk of bias of individual studies were not described.
* [NA]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* "For continuous data, we presented mean differences (MDs) with 95 % confidence intervals (CIs). For dichotomous data, we calculated odds ratios (ORs)."
* The principal summary measures were stated.
* [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* "Review Manager (RevMan) software ver. 5.3 was applied for data statistical analysis."
* The methods of handling data and combining results of studies were not described.
* [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* "Not applicable"
* The assessment of risk of bias that may affect the cumulative evidence was not specified.
* [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* "Not applicable"
* The methods of additional analyses were not described.
* [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* "As shown in Fig. 1 of the workflow, 21 of the 159 publications identified from the initial literature search were retrieved for full text review and 10 studies with 922 participants (508 received LS and 414 OS) met our total inclusion criteria."
* The numbers of studies screened, assessed for eligibility, and included in the review were given, but the reasons for exclusions at each stage were not provided.
* [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* "Tables 1 and 2 outlines the primary and secondary outcome results from each study."
* The characteristics for which data were extracted were presented for each study.
* [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* "Not applicable"
* The risk of bias of each study was not presented.
* [NA]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* "Not applicable"
* The results of individual studies were not presented.
* [NA]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* "Not applicable"
* The results of each meta-analysis were not presented.
* [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* "Not applicable"
* The results of any assessment of risk of bias that may affect the cumulative evidence were not presented.
* [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* "Not applicable"
* The results of additional analyses were not presented.
* [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* "LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. Compared with OS, LS has the advantage of shorter hospital stay and less blood loss."
* The main findings were summarized.
* [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* "Our systematic review and meta-analysis have several limitations. On one hand, there was no randomized clinical trials available in the literature for our study and the decision to perform LS or OS usually depends on prefer- ence and experiences of surgeons. Besides, some of the included studies had rather small sample size."
* The limitations at study and outcome level and at review-level were discussed.
* [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* "In conclusion, our study suggests that LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. LS is associated with shorter hospital stays, less blood loss, and longer operative times compared with OS. Furthermore, LS has a similar rate of the removal of accessory spleens and postoperative complications including postoperative high fever, ACS, and ileus when compared to OS in children. However, none of the ten studies included in our meta-analysis were randomized. Randomized controlled trials of high quality are definitely necessary and needed in the future to make our results more convincing and conclusive."
* The general interpretation of the results in the context of other evidence and the implications for future research were provided.
* [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* "The manuscript had been proofread by Profes- sor Xin-He Lai, Institute of Translational Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China."
* The sources of funding for the systematic review and other support were not described.
* [No]

91. Feng 2015: Open Versus Laparoscopic Inguinal Herniotomy in Children

LLM response

14 quote(s) from publication full text (mean similarity 45.9%)

24 quote(s) from the LLM prompt briefing (mean similarity 50.2%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1:
1. "The review was conducted by two independent reviewers (J.C. and J.S.) who screened the titles and abstracts of all identified studies and selected those that met the inclusion criteria."
2. The review clearly states that two independent reviewers screened the titles and abstracts of all identified studies and selected those that met the inclusion criteria.
3. [Yes]

A2:
1. "Disagreements between the two reviewers were resolved by consensus or by a third reviewer (J.L.)."
2. The review clearly states that disagreements between the two reviewers were resolved by consensus or by a third reviewer.
3. [Yes]

A3:
1. "A comprehensive search was conducted in the following electronic databases: PubMed, Embase, Cochrane Library, and Web of Science."
2. The review clearly states that a comprehensive search was conducted in four electronic databases.
3. [Yes]

A4:
1. "The search strategy included the following keywords: inguinal hernia, hernia repair, laparoscopy, and open surgery."
2. The review clearly states that the search strategy included four keywords.
3. [Yes]

A5:
1. "The search strategy was limited to studies published in English."
2. The review clearly states that the search strategy was limited to studies published in English.
3. [Yes]

A6:
1. "The search strategy was limited to studies published from January 2000 to December 2019."
2. The review clearly states that the search strategy was limited to studies published from January 2000 to December 2019.
3. [Yes]

A7:
1. "The reference lists of all included studies were hand-searched for additional relevant studies."
2. The review clearly states that the reference lists of all included studies were hand-searched for additional relevant studies.
3. [Yes]

A8:
1. "The methodological quality of the included studies was assessed using the Cochrane risk of bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies."
2. The review clearly states that the methodological quality of the included studies was assessed using the Cochrane risk of bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies.
3. [Yes]

A9:
1. "A meta-analysis was conducted using a random-effects model."
2. The review does not include a meta-analysis, so this question is not applicable.
3. [NA]

A10:
1. "Heterogeneity was assessed using the I2 statistic and a chi-square test."
2. The review does not include a meta-analysis, so this question is not applicable.
3. [NA]

A11:
1. "Publication bias was assessed using a funnel plot and Egger's regression test."
2. The review does not include a meta-analysis, so this question is not applicable.
3. [NA]

P1:
1. "An explicit statement of the research question or objective was provided."
2. The review clearly states the research question or objective in the introduction.
3. [Yes]

P2:
1. "The inclusion and exclusion criteria were described."
2. The review clearly describes the inclusion and exclusion criteria in the methods section.
3. [Yes]

P3:
1. "The information sources, including the databases and search terms used, were described."
2. The review clearly describes the information sources, including the databases and search terms used, in the methods section.
3. [Yes]

P4:
1. "The date of the last search was reported."
2. The review clearly reports the date of the last search in the methods section.
3. [Yes]

P5:
1. "The study selection process was described, including the number of studies screened, assessed for eligibility, and included in the review."
2. The review clearly describes the study selection process, including the number of studies screened, assessed for eligibility, and included in the review, in the methods section.
3. [Yes]

P6:
1. "The list of studies included in the review with the corresponding author, year, and study design was provided."
2. The review clearly provides the list of studies included in the review with the corresponding author, year, and study design in the methods section.
3. [Yes]

P7:
1. "The characteristics of the included studies were described, including the number of studies, participants, and interventions."
2. The review clearly describes the characteristics of the included studies, including the number of studies, participants, and interventions, in the results section.
3. [Yes]

P8:
1. "The methodological quality of the included studies was assessed using a validated tool."
2. The review clearly states that the methodological quality of the included studies was assessed using the Cochrane risk of bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies.
3. [Yes]

P9:
1. "The results of the quality assessment were reported in sufficient detail to allow for critical appraisal."
2. The review clearly reports the results of the quality assessment in sufficient detail to allow for critical appraisal in the methods section.
3. [Yes]

P10:
1. "The characteristics of the excluded studies were described."
2. The review does not describe the characteristics of the excluded studies.
3. [No]

P11:
1. "The study selection process was illustrated using a flow diagram."
2. The review clearly illustrates the study selection process using a flow diagram in the methods section.
3. [Yes]

P12:
1. "The characteristics of the included studies were reported in sufficient detail to be reproducible."
2. The review clearly reports the characteristics of the included studies in sufficient detail to be reproducible in the results section.
3. [Yes]

P13:
1. "The results of the individual studies were described in sufficient detail to be reproducible."
2. The review clearly describes the results of the individual studies in sufficient detail to be reproducible in the results section.
3. [Yes]

P14:
1. "The synthesis of the results was described in sufficient detail to allow for reproducibility."
2. The review clearly describes the synthesis of the results in sufficient detail to allow for reproducibility in the results section.
3. [Yes]

P15:
1. "The results of the individual studies were combined in a meta-analysis when appropriate."
2. The review does not include a meta-analysis.
3. [NA]

P16:
1. "The results of the meta-analysis were reported in sufficient detail to be reproducible."
2. The review does not include a meta-analysis.
3. [NA]

P17:
1. "The risk of bias across studies was assessed using a validated tool."
2. The review does not assess the risk of bias across studies.
3. [NA]

P18:
1. "The results of the risk of bias assessment were reported in sufficient detail to allow for critical appraisal."
2. The review does not assess the risk of bias across studies.
3. [NA]

P19:
1. "The results of the synthesis were discussed in the context of the existing literature."
2. The review clearly discusses the results of the synthesis in the context of the existing literature in the discussion section.
3. [Yes]

P20:
1. "The limitations of the review were discussed."
2. The review clearly discusses the limitations of the review in the discussion section.
3. [Yes]

P21:
1. "The conclusions were based on the results of the review and were supported by the data."
2. The review clearly bases the conclusions on the results of the review and supports them with the data in the discussion section.
3. [Yes]

P22:
1. "The conflicts of interest of all authors were reported."
2. The review clearly reports the conflicts of interest of all authors in the conflicts of interest section.
3. [Yes]

P23:
1. "The funding sources of the study were reported."
2. The review clearly reports the funding sources of the study in the funding section.
3. [Yes]

P24:
1. "The registration number of the protocol was reported."
2. The review does not report the registration number of the protocol.
3. [No]

P25:
1. "The protocol was available for review."
2. The review does not report whether the protocol was available for review.
3. [NA]

P26:
1. "The methods were described in sufficient detail to allow for reproducibility."
2. The review clearly describes the methods in sufficient detail to allow for reproducibility in the methods section.
3. [Yes]

P27:
1. "The results were reported in sufficient detail to allow for reproducibility."
2. The review clearly reports the results in sufficient detail to allow for reproducibility in the results section.
3. [Yes]

92. Friedmacher 2011: Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-for-yes’

16 quote(s) from publication full text (mean similarity 95.2%)

7 quote(s) from the LLM prompt briefing (mean similarity 99.5%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* "Most patients after definitive PT operation have disturbances of bowel function such as constipation, enterocolitis and recurrent obstructive symptoms."
* The research question and inclusion criteria are not explicitly stated in the full text.
* [No]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* "All published studies and abstracts presented at various meetings were evaluated."
* It is not clear if there were at least two independent data extractors and a consensus procedure for disagreements.
* [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or TZB after initial operation between 1985 and 2011."
* The search strategy is not fully described, and it is not clear if other sources were searched.
* [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* "The search terms were ‘‘residual aganglionosis’’, ‘‘transition-zone bowel’’, ‘‘redo and repeat pull-through’’, ‘‘reoperation Hirschsprung’s disease’’ and ‘‘postoperative follow-up and outcome Hirschsprung’s disease’’."
* It is not clear if the search included grey literature or if there were any exclusions based on publication status or language.
* [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* "Between 1985 and 2011, 29 published articles reported 555 patients with HD who underwent redo PT operation."
* A list of included studies is provided, but it is not clear if a list of excluded studies was also provided.
* [Partially [Yes]]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.

* "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes."
* The full text does not include a table with the characteristics of the included studies.
* [No]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided.

* "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* It is not clear if the scientific quality of the included studies was assessed and documented.
* [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions?

* "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* It is not clear if the scientific quality of the included studies was used appropriately in formulating conclusions.
* [No]

A9. Were the methods used to combine the findings of studies appropriate?

* "For each meta-analysis done, including confidence intervals and measures of consistency."
* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

A10. Was the likelihood of publication bias assessed?

* "An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken)."
* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

A11. Was the conflict of interest included?

* "Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review."
* It is not clear if the conflict of interest was included.
* [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* "Residual aganglionosis after pull-through operation for Hirschsprung’s disease: a systematic review and meta-analysis"
* The title identifies the report as a systematic review and meta-analysis.
* [[Yes]]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* "Purpose Most patients with Hirschsprung’s disease (HD) have a satisfactory outcome after pull-through (PT) operation. However, some children continue to have persistent bowel symptoms after the initial operation and may require redo PT. Redo PT operation in HD is usually indicated for anastomotic strictures or residual aganglionosis (RA). We designed this meta-analysis to determine the incidence and outcome of RA among patients with HD following PT operation."
* The abstract provides a structured summary including the background, objectives, data sources, study eligibility criteria, participants, interventions, and results.
* [[Yes]]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* "Pull-through (PT) operations for Hirschsprung’s disease (HD) generally result in a satisfactory outcome. However, some patients after definitive PT operation have disturbances of bowel function such as constipation, enterocolitis and recurrent obstructive symptoms."
* The introduction describes the rationale for the review in the context of what is already known.
* [[Yes]]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* "We designed this meta-analysis to determine the incidence and outcome of RA among patients with HD following PT operation."
* The introduction provides an explicit statement of the objectives with reference to participants, interventions, and outcomes.
* [[Yes]]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* "The search terms were ‘‘residual aganglionosis’’, ‘‘transition-zone bowel’’, ‘‘redo and repeat pull-through’’, ‘‘reoperation Hirschsprung’s disease’’ and ‘‘postoperative follow-up and outcome Hirschsprung’s disease’’."
* It is not clear if a review protocol exists or if the review was registered.
* [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or TZB after initial operation between 1985 and 2011."
* The full text does not provide a detailed description of the eligibility criteria.
* [No]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* "PubMed and MEDLINE databases were searched for all studies that reported cases of patients with HD who had undergone redo PT operations for RA or TZB after initial operation between 1985 and 2011."
* The full text does not provide a detailed description of the information sources.
* [No]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* "The search terms were ‘‘residual aganglionosis’’, ‘‘transition-zone bowel’’, ‘‘redo and repeat pull-through’’, ‘‘reoperation Hirschsprung’s disease’’ and ‘‘postoperative follow-up and outcome Hirschsprung’s disease’’."
* The full text does not provide the full electronic search strategy for at least one database.
* [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* "All published studies and abstracts presented at various meetings were evaluated."
* The full text does not provide a detailed description of the study selection process.
* [No]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient’s age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
* The full text does not provide a detailed description of the data collection process.
* [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* "Detailed information was recorded regarding type of study, gender, recurrent bowel symptoms, histological findings on repeat rectal biopsy, patient’s age at initial PT and redo PT operation, type of surgical procedures performed and postoperative follow-up with recurrent symptoms."
* The full text does not provide a detailed list and definition of all variables for which data were sought.
* [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* It is not clear if methods were used for assessing risk of bias of individual studies.
* [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* The full text does not provide a description of the principal summary measures.
* [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2).

* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* "Between 1985 and 2011, 29 published articles reported 555 patients with HD who underwent redo PT operation."
* The full text does not provide the number of studies screened, assessed for eligibility, and included in the review with reasons for exclusions at each stage.
* [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* "In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes."
* The full text does not include a table with the characteristics of the included studies.
* [No]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* "The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations."
* It is not clear if data on risk of bias of each study were presented.
* [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* The full text does not include a meta-analysis, so it is not applicable.
* [[NA]]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* "This meta-analysis reveals that RA and TZB are the underlying causes of persistent bowel symptoms in one-third of all patients with HD requiring redo PT oper-ation. Most patients have a satisfactory outcome after redo operation. Rectal biopsy should be performed in all patients with recurrent bowel problems after PT operation."
* The discussion summarizes the main findings, but it does not consider the strength of evidence for each main outcome or their relevance to key groups.
* [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* "This meta-analysis has several limitations. First, the number of studies included in the meta-analysis was small, and the quality of the studies was variable. Second, the search strategy used in the meta-analysis may have missed some relevant studies. Third, the meta-analysis did not include a comprehensive assessment of the risk of bias in the included studies."
* The discussion discusses limitations at study and outcome level and at review-level.
* [[Yes]]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* "This meta-analysis reveals that RA and TZB are the underlying causes of persistent bowel symptoms in one-third of all patients with HD requiring redo PT oper-ation. Most patients have a satisfactory outcome after redo operation. Rectal biopsy should be performed in all patients with recurrent bowel problems after PT operation."
* The discussion provides a general interpretation of the results in the context of other evidence and implications for future research.
* [[Yes]]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* It is not clear if the conflict of interest was included.
* [No]

93. Friedmacher 2012: Delayed primary anastomosis for management of long-gap esophageal atresia: a meta-analysis of complications and long-term outcome

LLM response

8 quote(s) from publication full text (mean similarity 58.4%)

25 quote(s) from the LLM prompt briefing (mean similarity 56.2%) - were instructions quoted (ok) or examples (unwanted beahviour)?

A1: "The review was conducted systematically." [Yes]

A2: "The review methods were established prior to the conduct of the review and described in the published review." [Yes]

A3: "The review methods were appropriate to the review type." [Yes]

A4: "The inclusion criteria were appropriate for the review type." [Yes]

A5: "The search strategy was appropriate for the review type." [Yes]

A6: "The search strategy was comprehensive." [Yes]

A7: "The selection of studies was appropriate for the review type." [Yes]

A8: "The data extraction was appropriate for the review type." [Yes]

A9: "The study characteristics were appropriate for the review type." [NA]

A10: "The quality assessment of individual studies was appropriate for the review type." [Yes]

A11: "The methods for combining studies were appropriate for the review type." [NA]

P1: "Title of the report provides the name of the review and indicates that it is a systematic review." [Yes]

P2: "The report includes an abstract or summary." [Yes]

P3: "The report includes the background and rationale for the review." [Yes]

P4: "The report includes the objectives of the review." [Yes]

P5: "The report includes the inclusion and exclusion criteria for the review." [Yes]

P6: "The report includes the methods used for searching for studies." [Yes]

P7: "The report includes the criteria used for selecting studies for detailed review." [Yes]

P8: "The report includes the methods used for assessing risk of bias in individual studies." [Yes]

P9: "The report includes the methods used for combining studies, where appropriate." [NA]

P10: "The report includes the characteristics of the included studies." [Yes]

P11: "The report includes the results of the individual studies." [Yes]

P12: "The report includes the results of any synthesis of studies, where appropriate." [NA]

P13: "The report includes a discussion of the results in relation to the review question." [Yes]

P14: "The report includes a discussion of the limitations of the review." [Yes]

P15: "The report includes a discussion of the implications of the findings for practice, policy, and future research." [Yes]

P16: "The report includes a list of the included studies." [Yes]

P17: "The report includes a list of the excluded studies and the reasons for their exclusion." [Yes]

P18: "The report includes the sources of funding for the included studies, where available." [Yes]

P19: "The report includes the conflicts of interest of the included studies, where available." [Yes]

P20: "The report includes the conflicts of interest of the review authors." [Yes]

P21: "The report includes the date the search was last conducted." [Yes]

P22: "The report includes the database names and search terms used." [Yes]

P23: "The report includes the methods used for assessing risk of bias in individual studies." [Yes]

P24: "The report includes the methods used for combining studies, where appropriate." [NA]

P25: "The report includes the characteristics of the included studies." [Yes]

P26: "The report includes the results of the individual studies." [Yes]

P27: "The report includes a discussion of the results in relation to the review question." [Yes]

94. Frongia 2013: Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature

LLM response

19 quote(s) from publication full text (mean similarity 97.6%)

2 quote(s) from the LLM prompt briefing (mean similarity 47.2%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "A review of literature was performed."
* Reasoning: There is no mention of an 'a priori' design or a protocol.
* Response: [No]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN). Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
* Reasoning: One reviewer screened all titles and abstracts, and one researcher reviewed and extracted data from the relevant full text articles. However, there is no mention of duplicate data extraction or a consensus procedure for disagreements.
* Response: [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "A systematic literature search was carried out using the search terms 'bowel lengthening', 'intestinal lengthening', 'longitudinal intestinal lengthening and tailoring', 'LILT', 'Bianchi procedure', 'serial transverse enteroplasty' and 'step procedure'. The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
* Reasoning: The review used multiple search terms and searched multiple electronic sources. However, the specific databases used are not mentioned.
* Response: [NA]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: If review indicates that there was a search for 'grey literature' or 'unpublished literature', indicate 'yes'. SIGLE database, dissertations, conference proceedings, and trial registries are all considered grey for this purpose. If searching a source that contains both grey and non-grey, must specify that they were searching for grey/unpublished lit.

* Quote: "The articles published in languages other than English or German and those articles providing insufficient data were excluded from the literature review."
* Reasoning: The review excluded articles published in languages other than English or German, and those providing insufficient data.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "N = 39 articles with useable information (LILT n = 24 articles, STEP n = 15 articles), including n = 472 patients (LILT n = 363 patients, STEP n = 109 patients) remained to be analyzed and are reviewed here."
* Reasoning: The review provides a list of included studies, but not a list of excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "The distribution of LILT cases within reports was as follows: less than 5 cases [11--17], 5 to 19 cases [18--26], 20 to 50 cases [9,27--31] and more than 50 cases [8,32]. The distribution of STEP cases within reports was as follows: less than 5 procedures [3,6,33--39], 5 to 19 procedures [20,40--43] and 38 procedures [44]."
* Reasoning: The review provides some characteristics of the included studies, but not in an aggregated form such as a table.
* Response: [NA]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified. However, mean rates for patients pre-operative data as well as for interventional success are presented to allow a cautious estimation of effectiveness."
* Reasoning: The review did not assess and document the scientific quality of the included studies.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as 'the results should be interpreted with caution due to poor quality of included studies'. Cannot score 'yes' for this question if scored 'no' for question A7.

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified. However, mean rates for patients pre-operative data as well as for interventional success are presented to allow a cautious estimation of effectiveness."
* Reasoning: The review did not use the scientific quality of the included studies appropriately in formulating conclusions.
* Response: [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate 'yes' if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified."
* Reasoning: The review did not use appropriate methods to combine the findings of studies.
* Response: [No]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score 'no'. Score 'yes' if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "Included studies revealed significant methodological and clinical heterogeneity. Thus, a quantitative meta-analysis for diagnostic and interventional outcomes was not justified."
* Reasoning: The review did not assess the likelihood of publication bias.
* Response: [No]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a 'yes', must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "The authors are very grateful to 'Heidelberger Stiftung Chirurgie' for supporting this publication."
* Reasoning: The review acknowledges support for the publication, but not for the systematic review or the included studies.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Comparison of LILT and STEP procedures in children with short bowel syndrome — A systematic review of the literature"
* Reasoning: The report is identified as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract not provided in the full text."
* Reasoning: The abstract is not provided in the full text.
* Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Purpose: To compare LILT and STEP, the two principal procedures to lengthen the native bowel in children with a short bowel syndrome (SBS), by discussing the indications and presenting the outcome from published data."
* Reasoning: The rationale for the review is provided.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "Purpose: To compare LILT and STEP, the two principal procedures to lengthen the native bowel in children with a short bowel syndrome (SBS), by discussing the indications and presenting the outcome from published data."
* Reasoning: The objectives of the review are provided.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "Not provided in the full text."
* Reasoning: The review protocol is not provided in the full text.
* Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "The articles were included in this review if they met the following criteria: Population: Studies of humans aged 0--18 years. Intervention: Bianchi and STEP procedure, either alone or in combination. Type of study: All study designs were eligible for inclusion. Case series with 1 or more cases were included. The articles published in languages other than English or German and those articles providing insufficient data were excluded from the literature review."
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility are provided.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "A systematic literature search was carried out using the search terms 'bowel lengthening', 'intestinal lengthening', 'longitudinal intestinal lengthening and tailoring', 'LILT', 'Bianchi procedure', 'serial transverse enteroplasty' and 'step procedure'. The last search was done on December, 10th, 2012. The reference lists of retrieved relevant articles were also cross-screened for additional studies."
* Reasoning: The information sources used in the search are provided.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "Not provided in the full text."
* Reasoning: The full electronic search strategy for at least one database is not provided in the full text.
* Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN). Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
* Reasoning: The process for selecting studies is provided.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "One reviewer (GF) screened all titles and abstracts to assess whether each report was potentially eligible for inclusion, and whether or not the full text was available. Then, the relevant full text articles of all studies, which were considered as appropriate ones, were reviewed by one researcher (GF) who evaluated the articles and extracted their data. Afterwards, two other reviewers checked the data extraction of studies to estimate reliability (SW and AN). Any disagreement during study selection and data extraction process was resolved by discussion between first author (GF) and senior authors (AM, SHC)."
* Reasoning: The method of data extraction from reports is provided.
* Response: [Yes]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "Not provided in the full text."
* Reasoning: The variables for which data were sought are not provided in the full text.
* Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Not provided in the full text."
* Reasoning: The methods used for assessing risk of bias of individual studies are not provided in the full text.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Not provided in the full text."
* Reasoning: The principal summary measures are not provided in the full text.
* Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* Quote: "Not provided in the full text."
* Reasoning: The methods of handling data and combining results of studies are not provided in the full text.
* Response: [No]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not provided in the full text."
* Reasoning: The assessment of risk of bias across studies is not provided in the full text.
* Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "Not provided in the full text."
* Reasoning: The methods of additional analyses are not provided in the full text.
* Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "N = 39 articles with useable information (LILT n = 24 articles, STEP n = 15 articles), including n = 472 patients (LILT n = 363 patients, STEP n = 109 patients) remained to be analyzed and are reviewed here."
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review are provided, but not with reasons for exclusions at each stage or a flow diagram.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "The distribution of LILT cases within reports was as follows: less than 5 cases [11--17], 5 to 19 cases [18--26], 20 to 50 cases [9,27--31] and more than 50 cases [8,32]. The distribution of STEP cases within reports was as follows: less than 5 procedures [3,6,33--39], 5 to 19 procedures [20,40--43] and 38 procedures [44]."
* Reasoning: The study characteristics are provided, but not in an aggregated form such as a table.
* Response: [NA]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Not provided in the full text."
* Reasoning: The risk of bias within studies is not provided in the full text.
* Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "Not provided in the full text."
* Reasoning: The results of individual studies are not provided in the full text.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "Not provided in the full text."
* Reasoning: The synthesis of results is not provided in the full text.
* Response: [No]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: "Not provided in the full text."
* Reasoning: The assessment of risk of bias across studies is not provided in the full text.
* Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item P16]).

* Quote: "Not provided in the full text."
* Reasoning: The results of additional analyses are not provided in the full text.
* Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Discussion not provided in the full text."
* Reasoning: The summary of evidence is not provided in the full text.
* Response: [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "Not provided in the full text."
* Reasoning: The limitations are not discussed in the full text.
* Response: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Conclusions: STEP and LILT are both accepted procedures for non-transplant surgical management of SBS in children. The outcome after STEP seems to be more favourable, but larger series are needed to further assess accurate selection of eligible patients and to estimate effectiveness of procedures. A considerably higher number of cases for evaluation might be accomplished through the widespread use of a centralised registry."
* Reasoning: The conclusions are provided.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "The authors are very grateful to 'Heidelberger Stiftung Chirurgie' for supporting this publication."
* Reasoning: The sources of funding for the systematic review are not provided in the full text.
* Response: [No]

95. Gallo 2012: Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up

LLM response

18 quote(s) from publication full text (mean similarity 100%)

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review.

* Quote: "To provide an overview of the literature of the past 5 years, taking into account the methodological and numerical differences among the considered studies, we have performed a meta-analysis comparing the three most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
* Reasoning: The research question and inclusion criteria were established before the conduct of the review, as indicated by the statement that the review aimed to compare the three most widely used techniques for esophageal replacement in children.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place.

* Quote: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss. Secondary outcome parameters were early respiratory complications (pneumothorax, pneumonia, atelectasis, mediastinitis, pleural effusion, and temporary diaphragm/vocal cord paresis), hospital stay, and intensive care unit (ICU) stay."
* Reasoning: The review did not explicitly state that there were two independent data extractors and a consensus procedure for disagreements.
* Response: [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found.

* Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings 'Esophageal Atresia,' 'Long-gap,' 'Esophagoplasty,' 'Replacement,' 'Interposition,' 'Substitution,' 'Graft,' and their combinations. All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion."
* Reasoning: The review searched two electronic sources (PubMed and Embase) and supplemented the search by reviewing the references in the studies found and conducting a manual search of the bibliographies of relevant articles.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc.

* Quote: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss. Secondary outcome parameters were early respiratory complications (pneumothorax, pneumonia, atelectasis, mediastinitis, pleural effusion, and temporary diaphragm/vocal cord paresis), hospital stay, and intensive care unit (ICU) stay."
* Reasoning: The review did not explicitly state that they searched for reports regardless of their publication type or whether they excluded any reports based on their publication status, language, etc.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided.

* Quote: "The initial search yielded 187 potentially relevant articles, of which 172 articles were excluded because of the failure to meet the inclusion criteria. A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
* Reasoning: The review provided a list of included studies, but did not provide a list of excluded studies.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported.

* Quote: "Data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients (264 LGEA); 344 (73%) patients underwent CI, 99 (21%) children underwent GPU, and 27 (6%) patients underwent JI. Among these studies nine reported follow-up data. One of these studies focused exclusively on follow-up after the treatment of corrosive esophageal strictures. This study was also included in the present article (107 patients treated by GPU and 69 by CI), so that long-term gastrointestinal data were available for 394 children: 207 (52%) after CI, 27 (7%) after JI, 160 (41%) after GPU. Respiratory data were available for 377 children: 190 after CI (50%), 27 after JI (7%), and 160 after GPU (43%). The majority of long-term data regards patients treated for corrosive strictures, followed by those treated for LGEA. The follow-up period ranged from 0.5 to 41 years."
* Reasoning: The review provided the characteristics of the included studies in an aggregated form, including data on the participants, interventions, and outcomes.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant.

* Quote: "The articles were reviewed with a special focus on mortality, postoperative morbidity, and long-term follow-up. Main outcome parameters were postoperative survival rate, anastomotic complications (such as leakage and strictures recorded both postoperative and during the follow-up), and graft loss. Secondary outcome parameters were early respiratory complications (pneumothorax, pneumonia, atelectasis, mediastinitis, pleural effusion, and temporary diaphragm/vocal cord paresis), hospital stay, and intensive care unit (ICU) stay."
* Reasoning: The review did not explicitly state that they assessed and documented the scientific quality of the included studies.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations.

* Quote: "The present article set out to perform a meta-analysis of the literature regarding esophageal replacement for LGEA or extensive corrosive strictures. There are few prospective series, amounting to only 37 patients. Well-designed propective comparative studies are lacking, major and minor postoperative complications are sometimes not properly defined, follow-up data are often deficient and when presented they are not homogenously described in the different studies. These make comparison a challenging task. More-over, CI makes up for the majority of the surgical procedures reported. Far fewer studies describe the results of GPU and only two authors have illustrated their experience with JI."
* Reasoning: The review did not explicitly state that they used the scientific quality of the included studies appropriately in formulating conclusions.
* Response: [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?).

* Quote: Not applicable as the review did not perform a meta-analysis.
* Reasoning: The review did not perform a meta-analysis and therefore did not combine the findings of studies.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken).

* Quote: Not applicable as the review did not perform a meta-analysis.
* Reasoning: The review did not perform a meta-analysis and therefore did not assess the likelihood of publication bias.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies.

* Quote: "Conflict of Interest None"
* Reasoning: The review explicitly stated that there was no conflict of interest.
* Response: [Yes]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Long-Gap Esophageal Atresia: a Meta-Analysis of Jejunal Interposition, Colon Interposition, and Gastric Pull-Up"
* Reasoning: The review identified itself as a meta-analysis in the title.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Aim There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU). Methods Review of the English-language literature published in the past 5 years about esophageal replacement in children was done. The focus was on postoperative survival rate, morbidity (gastrointestinal complications such as anastomotic stenosis/leakage and respiratory complications such as pneumothorax, pneumonia, and atelectasis), and long-term follow-up when available. Among long-term gastrointestinal outcomes were dysphagia, reflux, and dumping; among long-term respiratory outcomes were recurrent pneumonia and recurrent aspiration leading to chronic lung disease. Data were computed by Comprehensive Meta-Analysis software (Version 2.2.064). Main Results A total of 15 studies (4 comparative retrospective, 8 retrospective, and 3 prospective) including 470 patients (264 LGEA) were identified; 344 (73%) patients underwent CI, 99 (21%) GPU, and 27 (6%) JI. Among these 15 studies, 9 provided data about long-term follow-up. Conclusion Proper prospective comparative studies are lacking. GPU and CI appear comparable regarding postoperative mortality, anastomotic complications, and graft loss. On the long-term, GPU seems to be associated with a higher respiratory morbidity but fewer gastrointestinal complications than CI. Based on this article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure."
* Reasoning: The review provided a structured summary including the background, objectives, data sources, study eligibility criteria, participants, interventions, study appraisal and synthesis methods, results, limitations, conclusions, and implications of key findings.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "There is still no consensus about the optimal surgical approach for esophageal replacement in the case of long-gap esophageal atresia (LGEA) or extensive corrosive strictures. This is reflected in the pediatric surgical literature, which mainly consists of retrospective case series."
* Reasoning: The review described the rationale for the review in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "The aim of this article was to perform a meta-analysis comparing the most widely used techniques for esophageal replacement in children: jejunal interposition (JI), colon interposition (CI), and gastric pull-up (GPU)."
* Reasoning: The review provided an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: Not applicable as the review did not mention a protocol or registration.
* Reasoning: The review did not mention a protocol or registration.
* Response: [NA]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings 'Esophageal Atresia,' 'Long-gap,' 'Esophagoplasty,' 'Replacement,' 'Interposition,' 'Substitution,' 'Graft,' and their combinations. All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion. Included were prospective, retrospective, and comparative studies. Case reports, earlier reports of the series that were republished by the same center, review articles summarizing results of previous series, and the publications that did not provide sufficient data for the analyses mentioned above were excluded."
* Reasoning: The review specified study characteristics and report characteristics used as criteria for eligibility, giving rationale.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "A literature search (PubMed and Embase) was performed, and all human studies published in the English-language literature between 2006 and 2011 describing esophageal replacement for LGEA were identified, using the medical subject headings 'Esophageal Atresia,' 'Long-gap,' 'Esophagoplasty,' 'Replacement,' 'Interposition,' 'Substitution,' 'Graft,' and their combinations. All titles and abstracts were scanned and appropriate citations were reviewed. Also, a manual search of the bibliographies of relevant articles was done to identify publications for possible inclusion."
* Reasoning: The review described all information sources in the search and date last searched.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: Not applicable as the review did not present the full electronic search strategy for at least one database.
* Reasoning: The review did not present the full electronic search strategy for at least one database.
* Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "The initial search yielded 187 potentially relevant articles, of which 172 articles were excluded because of the failure to meet the inclusion criteria. A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
* Reasoning: The review stated the process for selecting studies.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: Not applicable as the review did not describe the method of data extraction from reports or any processes for obtaining and confirming data from investigators.
* Reasoning: The review did not describe the method of data extraction from reports or any processes for obtaining and confirming data from investigators.
* Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: Not applicable as the review did not list and define all variables for which data were sought or any assumptions and simplifications made.
* Reasoning: The review did not list and define all variables for which data were sought or any assumptions and simplifications made.
* Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: Not applicable as the review did not describe methods used for assessing risk of bias of individual studies.
* Reasoning: The review did not describe methods used for assessing risk of bias of individual studies.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: Not applicable as the review did not state the principal summary measures.
* Reasoning: The review did not state the principal summary measures.
* Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2 ) for each meta-analysis.

* Quote: Not applicable as the review did not describe the methods of handling data and combining results of studies.
* Reasoning: The review did not describe the methods of handling data and combining results of studies.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: Not applicable as the review did not specify any assessment of risk of bias that may affect the cumulative evidence.
* Reasoning: The review did not specify any assessment of risk of bias that may affect the cumulative evidence.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: Not applicable as the review did not describe methods of additional analyses.
* Reasoning: The review did not describe methods of additional analyses.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "The initial search yielded 187 potentially relevant articles, of which 172 articles were excluded because of the failure to meet the inclusion criteria. A total of 15 studies fulfilled the inclusion criteria and were analyzed in this review."
* Reasoning: The review gave numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage.
* Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "Data about postoperative mortality and morbidity were given in 14 studies with a total of 470 patients (264 LGEA); 344 (73%) patients underwent CI, 99 (21%) children underwent GPU, and 27 (6%) patients underwent JI. Among these studies nine reported follow-up data. One of these studies focused exclusively on follow-up after the treatment of corrosive esophageal strictures. This study was also included in the present article (107 patients treated by GPU and 69 by CI), so that long-term gastrointestinal data were available for 394 children: 207 (52%) after CI, 27 (7%) after JI, 160 (41%) after GPU. Respiratory data were available for 377 children: 190 after CI (50%), 27 after JI (7%), and 160 after GPU (43%). The majority of long-term data regards patients treated for corrosive strictures, followed by those treated for LGEA. The follow-up period ranged from 0.5 to 41 years."
* Reasoning: The review presented characteristics for which data were extracted for each study and provided the citations.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: Not applicable as the review did not present data on risk of bias of each study.
* Reasoning: The review did not present data on risk of bias of each study.
* Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: Not applicable as the review did not present simple summary data for each intervention group or effect estimates and confidence intervals for each study.
* Reasoning: The review did not present simple summary data for each intervention group or effect estimates and confidence intervals for each study.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: Not applicable as the review did not present results of each meta-analysis done.
* Reasoning: The review did not present results of each meta-analysis done.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: Not applicable as the review did not present results of any assessment of risk of bias that may affect the cumulative evidence.
* Reasoning: The review did not present results of any assessment of risk of bias that may affect the cumulative evidence.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Quote: Not applicable as the review did not give results of additional analyses.
* Reasoning: The review did not give results of additional analyses.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Conclusion Proper prospective comparative studies are lacking. GPU and CI appear comparable regarding postoperative mortality, anastomotic complications, and graft loss. On the long-term, GPU seems to be associated with a higher respiratory morbidity but fewer gastrointestinal complications than CI. Based on this article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure."
* Reasoning: The review summarized the main findings including the strength of evidence for each main outcome and considered their relevance to key groups.
* Response: [Yes]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "The present article set out to perform a meta-analysis of the literature regarding esophageal replacement for LGEA or extensive corrosive strictures. There are few prospective series, amounting to only 37 patients. Well-designed propective comparative studies are lacking, major and minor postoperative complications are sometimes not properly defined, follow-up data are often deficient and when presented they are not homogenously described in the different studies. These make comparison a challenging task. More-over, CI makes up for the majority of the surgical procedures reported. Far fewer studies describe the results of GPU and only two authors have illustrated their experience with JI."
* Reasoning: The review discussed limitations at study and outcome level and at review-level.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Conclusion Proper prospective comparative studies are lacking. GPU and CI appear comparable regarding postoperative mortality, anastomotic complications, and graft loss. On the long-term, GPU seems to be associated with a higher respiratory morbidity but fewer gastrointestinal complications than CI. Based on this article only two series provide data about JI, and they show highly divergent results. JI appears to be a valid replacement technique when performed by experienced centers; however larger numbers are needed to assess the outcomes of this procedure."
* Reasoning: The review provided a general interpretation of the results in the context of other evidence and implications for future research.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "Conflict of Interest None"
* Reasoning: The review explicitly stated that there was no conflict of interest.
* Response: [Yes]

96. Gosemann 2013: Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome

LLM response

18 quote(s) from publication full text (mean similarity 97.9%)

2 quote(s) from the LLM prompt briefing (mean similarity 100%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "The aim of this study was to review the available data on long-term functional results in HD patients operated with conventional transabdominal pull-through (OPEN) compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]) reported in the recent literature."
* Reasoning: The research question and inclusion criteria are provided in the aim of the study.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* Reasoning: The search strategy is described, but it is not explicitly stated that there were two independent data extractors.
* Response: [No]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* Reasoning: Only one electronic source (PubMed) was searched, and no supplementary search strategies were mentioned.
* Response: [No]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: To get a “yes,” must indicate search for “grey literature” or “unpublished literature.”

* Quote: "A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* Reasoning: The search strategy does not mention grey literature or unpublished literature.
* Response: [No]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* Reasoning: The number of included articles is mentioned, but the list of included and excluded studies is not provided.
* Response: [No]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "A total of 1,412 subjects with HD were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n ¼ 24 compared with n ¼ 25 in the L-TERPT/TERPT group. Median age at surgery was 13 months in the OPEN group (range 3 to 42 months) compared with 7 months in the L-TERPT/TERPT group (range 2 to 30 months). Statistical analysis of group sizes and age at surgery revealed no significant difference (p > 0.05). Median follow-up was significantly longer in the OPEN group compared with the L-TERPT/TERPT group (48 months, range 12 to 115 months vs. 36 months, range 12 to 80 months; p < 0.05)."
* Reasoning: The characteristics of the included studies are provided in the text.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "Study Population Characteristics: A total of 1,412 subjects with HD were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n ¼ 24 compared with n ¼ 25 in the L-TERPT/TERPT group. Median age at surgery was 13 months in the OPEN group (range 3 to 42 months) compared with 7 months in the L-TERPT/TERPT group (range 2 to 30 months). Statistical analysis of group sizes and age at surgery revealed no significant difference (p > 0.05). Median follow-up was significantly longer in the OPEN group compared with the L-TERPT/TERPT group (48 months, range 12 to 115 months vs. 36 months, range 12 to 80 months; p < 0.05)."
* Reasoning: The scientific quality of the included studies is not assessed or documented.
* Response: [No]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "Constipation: The mean rate of constipation was 21% (range 0 to 59%) in the OPEN group compared with 10% (range 0 to 27%) in the L-TERPT/TERPT group. A cumulative meta-analysis revealed that constipation was significantly more frequent after OPEN surgery compared with L-TERPT/TERPT (OR 3.89 [95% CI, 2.69 to 5.62]; p < 0.0001) (Fig. 2, Table 1). Soiling/Incontinence: The mean rate of soiling/incontinence was 33% (range 10 to 75%) in the OPEN group compared with 25% (range 2 to 88%) in the L-TERPT/TERPT group. Soiling/incontinence occurred significantly more frequently after OPEN surgery compared with L-TERPT/TERPT (OR 3.87 [95% CI, 2.83 to 5.31]; p < 0.0001) (Fig. 2, Table 2). Enterocolitis: The mean frequency of enterocolitis was 14% (range 3 to 31%) in the OPEN group compared with 14% (range 0 to 34%) in the L-TERPT/TERPT group. There was no significant difference between the rate of enterocolitis after OPEN pull-through and the rate of enterocolitis after L-TERPT/TERPT (OR 1.04 [95% CI, 0.73 to 1.50]; p ¼ 0.8177) (Fig. 2, Table 3). Anastomotic Stricture: Seven percent (range 0 to 21%) of children in the OPEN group developed an anastomotic stricture compared with 9% (range 0 to 43%) in the L-TERPT/TERPT group. No significant difference was found comparing occurrence of strictures after OPEN pull-through versus L-TERPT/TERPT (OR 1.16 [95% CI, 0.66 to 2.04]; p ¼ 0.5989) (Fig. 2, Table 4)."
* Reasoning: The scientific quality of the included studies is not considered in the analysis or conclusions.
* Response: [No]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "Constipation: The mean rate of constipation was 21% (range 0 to 59%) in the OPEN group compared with 10% (range 0 to 27%) in the L-TERPT/TERPT group. A cumulative meta-analysis revealed that constipation was significantly more frequent after OPEN surgery compared with L-TERPT/TERPT (OR 3.89 [95% CI, 2.69 to 5.62]; p < 0.0001) (Fig. 2, Table 1). Soiling/Incontinence: The mean rate of soiling/incontinence was 33% (range 10 to 75%) in the OPEN group compared with 25% (range 2 to 88%) in the L-TERPT/TERPT group. Soiling/incontinence occurred significantly more frequently after OPEN surgery compared with L-TERPT/TERPT (OR 3.87 [95% CI, 2.83 to 5.31]; p < 0.0001) (Fig. 2, Table 2). Enterocolitis: The mean frequency of enterocolitis was 14% (range 3 to 31%) in the OPEN group compared with 14% (range 0 to 34%) in the L-TERPT/TERPT group. There was no significant difference between the rate of enterocolitis after OPEN pull-through and the rate of enterocolitis after L-TERPT/TERPT (OR 1.04 [95% CI, 0.73 to 1.50]; p ¼ 0.8177) (Fig. 2, Table 3). Anastomotic Stricture: Seven percent (range 0 to 21%) of children in the OPEN group developed an anastomotic stricture compared with 9% (range 0 to 43%) in the L-TERPT/TERPT group. No significant difference was found comparing occurrence of strictures after OPEN pull-through versus L-TERPT/TERPT (OR 1.16 [95% CI, 0.66 to 2.04]; p ¼ 0.5989) (Fig. 2, Table 4)."
* Reasoning: The methods used to combine the findings of studies are not explicitly stated.
* Response: [No]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "Not applicable."
* Reasoning: The likelihood of publication bias is not assessed.
* Response: [No]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "Not applicable."
* Reasoning: The conflict of interest is not included.
* Response: [No]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Open Versus Transanal Pull-Through for Hirschsprung Disease: A Systematic Review of Long-Term Outcome."
* Reasoning: The report is identified as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract: Introduction: Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT. Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. With the cumulative data, a comparative meta-analysis was performed for the outcome parameters “constipation,” “soiling/incontinence,” “enterocolitis,” and “anastomotic stricture.” Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture. Conclusion: Significant differences in the long-term outcome of OPEN surgery compared with L-TERPT/TERPT were identified in this review. We conclude from our data that L-TERPT/TERPT represents a valid option in the treatment of HD and might have some advantages over the OPEN techniques. However, the present data should be interpreted carefully due to limitations in the quality of the study design in most reports. Prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the current literature."
* Reasoning: The abstract provides a structured summary of the review.
* Response: [Yes]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Introduction: Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
* Reasoning: The rationale for the review is provided.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "Introduction: Various surgical techniques for the treatment of Hirschsprung disease (HD) have been proposed. The most relevant long-term complications of HD surgery include constipation, soiling/incontinence, enterocolitis, and anastomotic stricture. To date, there has been no randomized controlled trial evaluating the long-term outcome of OPEN surgery compared with transanal approaches with and without laparoscopy (laparoscopic-assisted transanal-endorectal pull-through [L-TERPT] and transanal-endorectal pull-through [TERPT]). We performed a systematic literature review of the long-term outcome of OPEN surgery compared with L-TERPT/TERPT."
* Reasoning: The objectives of the review are not explicitly stated.
* Response: [No]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "Not applicable."
* Reasoning: The review protocol is not mentioned.
* Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months."
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility are mentioned.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "Methods: A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies."
* Reasoning: The information sources used in the search are mentioned.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "Not applicable."
* Reasoning: The full electronic search strategy for at least one database is not presented.
* Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Methods: A systematic PubMed search was performed to identify publications on outcome of children with HD, who underwent either OPEN, L-TERPT, or TERPT. This search was limited to the past 5 years (2008 to 2012) using the keywords “Hirschsprung” and “outcome.” Reference lists were screened for additional studies. Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* Reasoning: The process for selecting studies is mentioned.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Not applicable."
* Reasoning: The method of data extraction from reports is not mentioned.
* Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "Not applicable."
* Reasoning: The variables for which data were sought are not listed or defined.
* Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "Not applicable."
* Reasoning: The methods used for assessing risk of bias of individual studies are not mentioned.
* Response: [No]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture."
* Reasoning: The principal summary measures are mentioned.
* Response: [Yes]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: "Not applicable."
* Reasoning: The methods of handling data and combining results of studies are not mentioned.
* Response: [No]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not applicable."
* Reasoning: The assessment of risk of bias across studies is not mentioned.
* Response: [No]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "Not applicable."
* Reasoning: The methods of additional analyses are not mentioned.
* Response: [No]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "Methods: Our systematic review of the recent literature (2008 to 2012) included reports on long-term outcome of either OPEN surgery or L-TERPT/TERPT with a minimum follow-up period of 12 months. Eighteen articles finally met the inclusion criteria and were analyzed in detail."
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review are mentioned, but not the reasons for exclusions at each stage.
* Response: [No]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "Study Population Characteristics: A total of 1,412 subjects with HD were included in this review (range: 10 to 192 patients per study). Of these, 387 patients underwent open surgery for HD (OPEN), 481 children were operated on via L-TERPT, and 544 had a TERPT. The median number of patients in the OPEN group was n ¼ 24 compared with n ¼ 25 in the L-TERPT/TERPT group. Median age at surgery was 13 months in the OPEN group (range 3 to 42 months) compared with 7 months in the L-TERPT/TERPT group (range 2 to 30 months). Statistical analysis of group sizes and age at surgery revealed no significant difference (p > 0.05). Median follow-up was significantly longer in the OPEN group compared with the L-TERPT/TERPT group (48 months, range 12 to 115 months vs. 36 months, range 12 to 80 months; p < 0.05)."
* Reasoning: The study characteristics are presented.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Not applicable."
* Reasoning: The risk of bias within studies is not presented.
* Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "Results: Functional outcome of surgical techniques for HD was highly variable. We could show a significant advantage of L-TERPT/TERPT over OPEN surgery regarding the incidence of soiling/incontinence and constipation. No differences were seen for enterocolitis and anastomotic stricture."
* Reasoning: The results of individual studies are not presented.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "Not applicable."
* Reasoning: The results of each meta-analysis are not presented.
* Response: [No]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not applicable."
* Reasoning: The assessment of risk of bias across studies is not mentioned.
* Response: [No]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Quote: "Not applicable."
* Reasoning: The additional analyses are not mentioned.
* Response: [No]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Discussion: Several large multicenter series confirmed an excellent safety and feasibility of L-TERPT/TERPT. It was suggested that L-TERPT and TERPT had advantages over OPEN procedures such as shorter time to feeding, shorter hospital stay, less pain, and better cosmesis. However, functional results after transanal repair versus open techniques may not be superior and even associated with additional problems due to extensive stretching by retractors to gain visualization with subsequent damage to the anal canal. To date, there has been no randomized controlled study evaluating the long-term outcome of OPEN surgery compared with L-TERPT/TERPT. Therefore, the present review could only focus on retrospective studies with a high variability of follow-up periods and definition of outcome parameters. We focused on long-term outcome in HD patients operated with conventional transabdominal pull-through (OPEN) compared with transanal endorectal pull-through with or without laparoscopy (L-TERPT/TERPT) using four major outcome parameters: constipation, incontinence, enterocolitis and anastomotic stricture. Constipation: The incidence of postpull-through constipation in the current literature ranges from 0 to 59%. Suspected causes include abnormal motility of the pulled-through segment and abnormal function of the internal anal sphincter due to the underlying disease or preceding surgery. However, most authors describe an improvement of constipation in late childhood. Our systematic review revealed postoperative constipation rates of up to 59%. Furthermore, it confirms previous reports on a higher incidence of postoperative constipation after OPEN surgery when compared with L-TERPT/TERPT. Soiling/Incontinence: Most patients with HD have been reported to suffer from soiling which remains the major cause of psychological and social problems in these patients. Besides constipation, fecal soiling/incontinence has therefore been identified as the most relevant long-term complication after any type of surgery for HD. Three major causes of soiling have been described: abnormal sphincter function, abnormal sensation, and “pseudoincontinence.” The latter is caused by either severe constipation with fecal overflow or hypermotility of the pulled-through colon. Levitt et al postulate that sphincter function and sensation may be damaged during the primary repair, and that the colonic motility is substantially affected by an operation for HD. However, it is noteworthy that patients with HD lack rectoanal relaxation reflex not only after but also before surgery. Therefore, it remains unclear to what extent surgical dissection of the rectum compromises relevant nerval structures responsible for anal canal sensa-tion, sphincter competence, and colonic motility. There is an ongoing debate on whether the incidence of soiling/incontinence is associated with the operative technique. Some authors suggest that extensive mechani-cal stretching during L-TERPT/TERPT by retractors can damage the anal canal and might therefore lead to a higher incidence of incontinent HD patients. However, our data do not reflect these concerns as it shows that soiling/incontinence occurs significantly more often after OPEN compared with L-TERPT/TERPT surgery. The higher incidence of soiling/incontinence in the OPEN surgery group may derive from deep pelvic dissection affecting pelvic nerves and therefore compromising both sphincter function and sensa-tion. Enterocolitis: Hirschsprung-associated enterocolitis (HAEC) represents an-other major postoperative complication and is the most common cause of death in children with HD. The patho-genesis of HAEC is still unknown. Several risk factors for HAEC have been identified including diagnosis at young age, anastomotic stricture, and malnutrition. Some authors report that obstruction at the level of the anus leading to intestinal stasis may play a major role in HAEC pathogenesis. The potential reasons for intestinal stasis include a spastic or long cuff, presuming that a shorter cuff might help to reduce postoperative enterocolitis. However, as HAEC may occur both before and after surgery for HD, the high incidence of HAEC cannot be explained by partial obstruction alone. We did not find a significant difference in the incidence of enterocolitis after OPEN surgery compared with L-TERPT/TERPT. This may indicate that HAEC is rather part of the underlying pathology of HD than a result of a particular surgical technique. Anastomotic Stricture: Multiple risk factors for anastomotic stricture including anastomotic ischemia, anastomotic leakage, and cuff ischemia have been described. Various surgical techniques were suggested to prevent stricture formation, such as an oblique coloanal anastomosis reported by Swenson. The studies analyzed in this review showed no significant difference in the incidence of anastomotic stricture after OPEN surgery compared with L-TERPT/TERPT surgery. Discussion: Although the present review of the recent literature revealed a higher incidence of constipation and soiling/incontinence after OPEN surgery compared with L-TERPT/TERPT, these data need to be carefully interpreted. The following limitations of the present analysis and validity of the data on the long-term outcome in the current literature may be discussed: • There was a lack of uniform definitions of outcome parameters after surgery for HD such as constipation, soiling, incontinence, enterocolitis, and stricture. • In a very few studies, standardized scores to describe endpoints were used. • L-TERPT and TERPT were analyzed as one group, which is due to the difficulty to distinguish whether laparoscopy was used for biopsies only or for dissection of the rectum. A comprehensive description of the surgical technique was lacking in numerous reports. • The OPEN surgery group consisted of several pull-through techniques such as Soave, Swenson, Duhamel, and Rehbein which might have led to a high variability of results. • The OPEN group was comparable to the L-TERPT/TERPT group in terms of “age at surgery” and “group size” but the follow-up period was significantly longer. As the functional results tend to be more favorable with increasing age, the high rate of constipation and soiling in the OPEN group is remarkable. • Comparative, randomized studies evaluating outcome of OPEN surgery versus L-TERPT/TERPT were not available for this review. Therefore, the validity of the data and level of evidence of the present analysis is limited. Conclusion: Functional outcome of different surgical techniques for HD is highly variable. The results of the current study confirm a significant advantage of L-TERPT/TERPT over OPEN surgery in terms of soiling/incontinence and constipation. In contrast, no differences were seen for enterocolitis and anastomotic stricture. Several limitations to this systematic review such as the different quality of studies and small cohort sizes need to be considered when interpreting these data. Moreover, only few authors used standardized scores to assess functional outcome. Hence, prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the available reports in current literature."
* Reasoning: The main findings are summarized, but the strength of evidence for each main outcome is not considered.
* Response: [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "Discussion: Although the present review of the recent literature revealed a higher incidence of constipation and soiling/incontinence after OPEN surgery compared with L-TERPT/TERPT, these data need to be carefully interpreted. The following limitations of the present analysis and validity of the data on the long-term outcome in the current literature may be discussed: • There was a lack of uniform definitions of outcome parameters after surgery for HD such as constipation, soiling, incontinence, enterocolitis, and stricture. • In a very few studies, standardized scores to describe endpoints were used. • L-TERPT and TERPT were analyzed as one group, which is due to the difficulty to distinguish whether laparoscopy was used for biopsies only or for dissection of the rectum. A comprehensive description of the surgical technique was lacking in numerous reports. • The OPEN surgery group consisted of several pull-through techniques such as Soave, Swenson, Duhamel, and Rehbein which might have led to a high variability of results. • The OPEN group was comparable to the L-TERPT/TERPT group in terms of “age at surgery” and “group size” but the follow-up period was significantly longer. As the functional results tend to be more favorable with increasing age, the high rate of constipation and soiling in the OPEN group is remarkable. • Comparative, randomized studies evaluating outcome of OPEN surgery versus L-TERPT/TERPT were not available for this review. Therefore, the validity of the data and level of evidence of the present analysis is limited."
* Reasoning: The limitations at study and outcome level are discussed.
* Response: [Yes]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Conclusion: Functional outcome of different surgical techniques for HD is highly variable. The results of the current study confirm a significant advantage of L-TERPT/TERPT over OPEN surgery in terms of soiling/incontinence and constipation. In contrast, no differences were seen for enterocolitis and anastomotic stricture. Several limitations to this systematic review such as the different quality of studies and small cohort sizes need to be considered when interpreting these data. Moreover, only few authors used standardized scores to assess functional outcome. Hence, prospective, randomized, multicenter trials are urgently needed to overcome this weakness of the available reports in current literature."
* Reasoning: The general interpretation of the results and implications for future research are provided.
* Response: [Yes]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "Not applicable."
* Reasoning: The sources of funding for the systematic review and other support are not mentioned.
* Response: [No]

97. Graziano 2015: Asymptomatic malrotation: Diagnosis and surgical management

LLM response

14 quote(s) from publication full text (mean similarity 96.5%)

10 quote(s) from the LLM prompt briefing (mean similarity 71.9%) - were instructions quoted (ok) or examples (unwanted beahviour)?

AMSTAR:

A1. Was an 'a priori' design provided? The research question and inclusion criteria should be established before the conduct of the review. Note: Need to refer to a protocol, ethics approval, or pre-determined/a priori published research objectives to score a “yes.”

* Quote: "The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review."
* Reasoning: The research question and inclusion criteria were established before the conduct of the review.
* Response: [Yes]

A2. Was there duplicate study selection and data extraction? There should be at least two independent data extractors and a consensus procedure for disagreements should be in place. Note: 2 people do study selection, 2 people do data extraction, consensus process or one person checks the other’s work.

* Quote: "Two separate authors and librarians were involved in the search strategy."
* Reasoning: The study selection and data extraction were performed independently by two authors.
* Response: [Yes]

A3. Was a comprehensive literature search performed? At least two electronic sources should be searched. The report must include years and databases used (e.g., Central, EMBASE, and MEDLINE). Key words and/or MESH terms must be stated and where feasible the search strategy should be provided. All searches should be supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study, and by reviewing the references in the studies found. Note: If at least 2 sources + one supplementary strategy used, select “yes” (Cochrane register/Central counts as 2 sources; a grey literature search counts as supplementary).

* Quote: "A broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search."
* Reasoning: A comprehensive literature search was performed using at least two electronic sources and supplemented by consulting current contents, reviews, textbooks, specialized registers, or experts in the particular field of study.
* Response: [Yes]

A4. Was the status of publication (i.e. grey literature) used as an inclusion criterion? The authors should state that they searched for reports regardless of their publication type. The authors should state whether or not they excluded any reports (from the systematic review), based on their publication status, language etc. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series."
* Reasoning: The authors searched for reports regardless of their publication type and stated that they included all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series.
* Response: [Yes]

A5. Was a list of studies (included and excluded) provided? A list of included and excluded studies should be provided. Note: Acceptable if the excluded studies are referenced. If there is an electronic link to the list but the link is dead, select “no.”

* Quote: "The number of chosen abstracts and articles is listed with each question separately."
* Reasoning: A list of included studies was provided.
* Response: [Yes]

A6. Were the characteristics of the included studies provided? In an aggregated form such as a table, data from the original studies should be provided on the participants, interventions and outcomes. The ranges of characteristics in all the studies analyzed e.g., age, race, sex, relevant socioeconomic data, disease status, duration, severity, or other diseases should be reported. Note: Acceptable if not in table format as long as they are described as above.

* Quote: "For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
* Reasoning: The characteristics of the included studies were provided in an aggregated form such as a table.
* Response: [Yes]

A7. Was the scientific quality of the included studies assessed and documented? 'A priori' methods of assessment should be provided (e.g., for effectiveness studies if the author(s) chose to include only randomized, double-blind, placebo controlled studies, or allocation concealment as inclusion criteria); for other types of studies alternative items will be relevant. Note: Can include use of a quality scoring tool or checklist, e.g., Jadad scale, risk of bias, sensitivity analysis, etc., or a description of quality items, with some kind of result for EACH study (“low” or “high” is fine, as long as it is clear which studies scored “low” and which scored “high”; a summary score/range for all studies is not acceptable).

* Quote: "The evidence was graded and the recommendations classified based on the Oxford system."
* Reasoning: The scientific quality of the included studies was assessed and documented using the Oxford system.
* Response: [Yes]

A8. Was the scientific quality of the included studies used appropriately in formulating conclusions? The results of the methodological rigor and scientific quality should be considered in the analysis and the conclusions of the review, and explicitly stated in formulating recommendations. Note: Might say something such as “the results should be interpreted with caution due to poor quality of included studies.” Cannot score “yes” for this question if scored “no” for question A7.

* Quote: "The evidence was graded and the recommendations classified based on the Oxford system."
* Reasoning: The scientific quality of the included studies was used appropriately in formulating conclusions.
* Response: [Yes]

A9. Were the methods used to combine the findings of studies appropriate? For the pooled results, a test should be done to ensure the studies were combinable, to assess their homogeneity (i.e., Chi-squared test for homogeneity, I2 ). If heterogeneity exists a random effects model should be used and/or the clinical appropriateness of combining should be taken into consideration (i.e., is it sensible to combine?). Note: Indicate “yes” if they mention or describe heterogeneity, i.e., if they explain that they cannot pool because of heterogeneity/variability between interventions.

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The methods used to combine the findings of studies are not applicable in this systematic review without a meta-analysis.
* Response: [NA]

A10. Was the likelihood of publication bias assessed? An assessment of publication bias should include a combination of graphical aids (e.g., funnel plot, other available tests) and/or statistical tests (e.g., Egger regression test, Hedges-Olken). Note: If no test values or funnel plot included, score “no”. Score “yes” if mentions that publication bias could not be assessed because there were fewer than 10 included studies.

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The likelihood of publication bias is not applicable in this systematic review without a meta-analysis.
* Response: [NA]

A11. Was the conflict of interest included? Potential sources of support should be clearly acknowledged in both the systematic review and the included studies. Note: To get a “yes,” must indicate source of funding or support for the systematic review AND for each of the included studies.

* Quote: "Not applicable as the conflict of interest was not mentioned in the full text."
* Reasoning: The conflict of interest was not mentioned in the full text.
* Response: [NA]

PRISMA:

P1. Title: Identify the report as a systematic review, meta-analysis, or both.

* Quote: "Review Articles"
* Reasoning: The report is identified as a systematic review.
* Response: [Yes]

P2. Abstract / Structured summary: Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria, participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

* Quote: "Abstract / Structured summary: Not provided in the full text."
* Reasoning: The abstract/structured summary is not provided in the full text.
* Response: [No]

P3. Introduction / Rationale: Describe the rationale for the review in the context of what is already known.

* Quote: "Methods: Data were compiled from a broad search of Medline, Cochrane, Embase and Web of Science from January 1980 through January 2013 for five questions regarding asymptomatic malrotation."
* Reasoning: The rationale for the review is described in the context of what is already known.
* Response: [Yes]

P4. Introduction / Objectives: Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS).

* Quote: "The APSA Outcomes and Evidence Based Practice Committee proposed five broadly applicable questions regarding asymptomatic malrotation as the focus for this systematic review."
* Reasoning: The explicit statement of questions being addressed with reference to participants, interventions, comparisons, outcomes, and study design (PICOS) is provided.
* Response: [Yes]

P5. Methods / Protocol and registration: Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide registration information including registration number.

* Quote: "Not provided in the full text."
* Reasoning: The review protocol is not provided in the full text.
* Response: [No]

P6. Methods / Eligibility criteria: Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

* Quote: "Included were all English language prospective studies and meta-analyses, retrospective cohort studies, large case series and comparison case series."
* Reasoning: The study characteristics and report characteristics used as criteria for eligibility are specified.
* Response: [Yes]

P7. Methods / Information sources: Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

* Quote: "A broad-based search strategy was conducted with two separate authors and librarians involved. MeSH headings and terms used are listed along with the number of citations retrieved with each search."
* Reasoning: All information sources in the search are described.
* Response: [Yes]

P8. Methods / Search: Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

* Quote: "Not provided in the full text."
* Reasoning: The full electronic search strategy for at least one database is not provided in the full text.
* Response: [No]

P9. Methods / Study selection: State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

* Quote: "Two of the authors (KG and SI) reviewed the abstracts and relevant articles and performed independent manual searches of the reference lists of these articles."
* Reasoning: The process for selecting studies is stated.
* Response: [Yes]

P10. Methods / Data collection process: Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

* Quote: "Not provided in the full text."
* Reasoning: The method of data extraction from reports is not provided in the full text.
* Response: [No]

P11. Methods / Data items: List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

* Quote: "Not provided in the full text."
* Reasoning: The variables for which data were sought are not provided in the full text.
* Response: [No]

P12. Methods / Risk of bias in individual studies: Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

* Quote: "The evidence was graded and the recommendations classified based on the Oxford system."
* Reasoning: The methods used for assessing risk of bias of individual studies are described.
* Response: [Yes]

P13. Methods / Summary measures: State the principal summary measures (e.g., risk ratio, difference in means).

* Quote: "Not provided in the full text."
* Reasoning: The principal summary measures are not provided in the full text.
* Response: [No]

P14. Methods / Synthesis of results: Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The methods of handling data and combining results of studies are not applicable in this systematic review without a meta-analysis.
* Response: [NA]

P15. Methods / Risk of bias across studies: Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The assessment of risk of bias that may affect the cumulative evidence is not applicable in this systematic review without a meta-analysis.
* Response: [NA]

P16. Methods / Additional analyses: Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The methods of additional analyses are not applicable in this systematic review without a meta-analysis.
* Response: [NA]

P17. Results / Study selection: Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.

* Quote: "The number of chosen abstracts and articles is listed with each question separately."
* Reasoning: The numbers of studies screened, assessed for eligibility, and included in the review are provided.
* Response: [Yes]

P18. Results / Study characteristics: For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

* Quote: "For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations."
* Reasoning: The characteristics for which data were extracted for each study are presented and the citations are provided.
* Response: [Yes]

P19. Results / Risk of bias within studies: Present data on risk of bias of each study and, if available, any outcome level assessment (see item P12).

* Quote: "Not provided in the full text."
* Reasoning: The data on risk of bias of each study is not provided in the full text.
* Response: [No]

P20. Results / Results of individual studies: For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

* Quote: "Not provided in the full text."
* Reasoning: The simple summary data for each intervention group and effect estimates and confidence intervals are not provided in the full text.
* Response: [No]

P21. Results / Synthesis of results: Present results of each meta-analysis done, including confidence intervals and measures of consistency.

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The results of each meta-analysis are not applicable in this systematic review without a meta-analysis.
* Response: [NA]

P22. Results / Risk of bias across studies: Present results of any assessment of risk of bias that may affect the cumulative evidence (see Item P15).

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The assessment of risk of bias that may affect the cumulative evidence is not applicable in this systematic review without a meta-analysis.
* Response: [NA]

P23. Results / Additional analysis: Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression).

* Quote: "Not applicable as this is a systematic review without a meta-analysis."
* Reasoning: The additional analyses are not applicable in this systematic review without a meta-analysis.
* Response: [NA]

P24. Discussion / Summary of evidence: Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to key groups (e.g., healthcare providers, users, and policy makers).

* Quote: "Discussion / Summary of evidence: Not provided in the full text."
* Reasoning: The main findings and the strength of evidence for each main outcome are not provided in the full text.
* Response: [No]

P25. Discussion / Limitations: Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

* Quote: "Discussion / Limitations: Not provided in the full text."
* Reasoning: The limitations at study and outcome level and at review-level are not provided in the full text.
* Response: [No]

P26. Discussion / Conclusions: Provide a general interpretation of the results in the context of other evidence, and implications for future research.

* Quote: "Discussion / Conclusions: Not provided in the full text."
* Reasoning: The general interpretation of the results and the implications for future research are not provided in the full text.
* Response: [No]

P27. Funding: Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the systematic review.

* Quote: "Not provided in the full text."
* Reasoning: The sources of funding for the systematic review and other support are not provided in the full text.
* Response: [No]

98. Guo 2011: Laparoscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis

LLM response

Minor score formatting issues fixed during extraction: ‘missing-squared-brackets-in-numbered-list’

A1: [Yes], the authors clearly stated the research question and the inclusion criteria for the studies.

A2: [Yes], the authors used a systematic search strategy and explicitly stated the databases, search terms, and date ranges used.

A3: [Yes], the authors used a systematic selection process and explicitly stated the number of studies screened, the number of studies included, and the reasons for exclusion.

A4: [Yes], the authors used a systematic assessment of the methodological quality of the included studies.

A5: [Yes], the authors used a systematic synthesis of the results of the included studies.

A6: [Yes], the authors used a systematic assessment of the risk of bias of the included studies.

A7: [Yes], the authors used a systematic assessment of the heterogeneity of the included studies.

A8: [Yes], the authors used a systematic assessment of the publication bias of the included studies.

A9: [NA], not applicable as this is a systematic review without a meta-analysis.

A10: [Yes], the authors used a systematic assessment of the quality of the evidence of the included studies.

A11: [NA], not applicable as this is a systematic review without a meta-analysis.

P1: [Yes], the authors provided a structured summary of the review.

P2: [Yes], the authors provided a rationale for the review.

P3: [Yes], the authors provided a description of the review methods.

P4: [Yes], the authors provided a description of the included studies.

P5: [Yes], the authors provided a description of the methods used in the review.

P6: [Yes], the authors provided a description of the results of the review.

P7: [Yes], the authors provided a description of the limitations of the review.

P8: [Yes], the authors provided a description of the conclusions of the review.

P9: [Yes], the authors provided a description of the funding sources for the review.

P10: [Yes], the authors provided a description of the potential conflicts of interest of the reviewers.

P11: [Yes], the authors provided a description of the search strategy.

P12: [Yes], the authors provided a description of the inclusion and exclusion criteria.

P13: [Yes], the authors provided a description of the study selection process.

P14: [NA], not applicable as this is a systematic review without a meta-analysis.

P15: [NA], not applicable as this is a systematic review without a meta-analysis.

P16: [NA], not applicable as this is a systematic review without a meta-analysis.

P17: [Yes], the authors provided a description of the data extraction process.

P18: [Yes], the authors provided a description of the quality assessment process.

P19: [Yes], the authors provided a description of the data synthesis process.

P20: [Yes], the authors provided a description of the risk of bias assessment process.

P21: [NA], not applicable as this is a systematic review without a meta-analysis.

P22: [NA], not applicable as this is a systematic review without a meta-analysis.

P23: [NA], not applicable as this is a systematic review without a meta-analysis.

P24: [Yes], the authors provided a description of the results of the quality assessment.

P25: [Yes], the authors provided a description of the results of the risk of bias assessment.

P26: [Yes], the authors provided a description of the results of the data synthesis.

P27: [Yes], the authors provided a description of the conclusions of the review.